Surgical Management of Extracranial Carotid Artery Aneurysms: Report of 17 Cases

This article reviews the operative techniques, results, and complications associated with the treatment of 17 extracranial carotid artery aneurysms encountered in an overall experience of 6,096 carotid endarterectomies during a 24-year period. All 17 patients were operated upon because of severe symptoms and the potential for stroke. Eight patients underwent an aneurysmorrhaphy with Dacron-patch angioplasty; 7 had resection of the aneurysm, with end-to-end anastomosis and Dacron-patch angioplasty; and 2 underwent clipping of the aneurysm. There was 1 hospital death, in the case of a patient who sustained a postoperative myocardial infarction. Three patients had a postoperative neurologic deficit; this complication was permanent in 1 case and transient in 2. During long-term follow-up, no late stroke occurred; nevertheless, 3 patients died of a myocardial infarction, for an overall 5-year survival rate of 77%. On the basis of this study, we conclude that accessible aneurysms of the extracranial carotid artery can be excised with an acceptable morbidity and mortality.