EXTRACRANIAL CAROTID-ARTERY ANEURYSMS

This article reviews the etiology clinical manifestations, operative t echniques, and results of management of fourteen cases of extracranial carotid artery aneurysms, operated upon in our institution between Se ptember 1990 and August 1994. Except for one, they were elective opera tions. Aneurysmectomy with restoration of continuity by direct anastom osis was done in four cases, an autogenous saphenous Vein graft was pe rformed in one, and prosthetic grafts (Dacron) in three. Local conditi ons precluded restoration of arterial continuity in two cases. Two pat ients underwent exclusion and bypass graft, and one underwent exclusio n only. Ligation was resorted to in one patient, who was subjected to emergency surgery due to rupture of the aneurysm. A temporary, intra-o perative, extraluminal carotid artery shunt was used in only one patie nt, as all the others had angiographic evidence of satisfactory cerebr al cross-circulation. Two patients developed transient, neurological d eficits in the post-operative period. There was no mortality. We concl ude that aneurysms of the extracranial carotid arteries can be operate d on with minimal morbidity and no mortality. Operative management is the treatment of choice because of their potential neurological compli cations, if left untreated.