Extracranial internal carotid artery aneurysms: Results of a surgical series with long-term follow-up

Autor: Andrea Stella, Gianluca Faggioli, Mauro Gargiulo, Antonio Freyrie, L. Pedrini, Salvatore Tarantini, John J. Ricotta, M. D'Addato
Jazyk: angličtina
Předmět:
Carotid Artery Diseases
Male
Reoperation
medicine.medical_specialty
Arteriosclerosis
External carotid artery
Fibromuscular dysplasia
Anesthesia
General
Duplex scanning
Surgical anastomosis
Aneurysm
Postoperative Complications
medicine.artery
medicine
Fibromuscular Dysplasia
Humans
Saphenous Vein
Longitudinal Studies
Elective surgery
Polytetrafluoroethylene
Aged
Retrospective Studies
Neurologic Examination
Ultrasonography
Doppler
Duplex
Vascular disease
business.industry
Anastomosis
Surgical
Prostheses and Implants
Middle Aged
medicine.disease
Cranial Nerve Diseases
Surgery
Blood Vessel Prosthesis
Survival Rate
Cerebrovascular Disorders
Elective Surgical Procedures
Population Surveillance
Carotid Artery
External
Female
Radiology
Internal carotid artery
Cardiology and Cardiovascular Medicine
business
Carotid Artery
Internal
Follow-Up Studies
Zdroj: Journal of Vascular Surgery. (4):587-595
ISSN: 0741-5214
DOI: 10.1016/S0741-5214(96)80037-1
Popis: The purpose of this study was to analyze mode of presentation, surgical treatment, and early and long-term results of a series of extracranial internal carotid artery aneurysms (EICAA).A retrospective analysis was performed on all cases treated for EICAA in a single institution from March 1974 to March 1995. Patient follow-up was obtained by a surveillance protocol, with duplex scanning performed 3 months after surgery and yearly thereafter.Twenty-four EICAA in 20 patients were treated over a 21-year period. The cause was fibromuscular dysplasia in 12 cases (50%), nonspecific "atherosclerosis" in nine (37.5%), previous carotid artery surgery in two (8.3%), and trauma in one case (4.1%). Neurologic symptoms were present in a total of nine cases (37.5%) and were hemispheric in seven (29.1%) and nonhemispheric in two (8.3%). Operative techniques were performed with patients receiving general anesthetic and included aneurysm excision with internal carotid artery reanastomosis (8 cases [33.3%]) or reimplantation onto the external carotid artery (1 case [4.1%]); interposition graft (10 cases [41.6%]), 7 veins, 3 polytetrafluoroethylene) or simple aneurysmectomy and closure of the wall defect either with (3 cases [12.5%]) or without (2 cases [8.3%]) a patch. Elective surgery was performed in 22 cases, with a 0% mortality rate and 4.5% stroke rate. Emergency operations were performed in two cases of ruptured aneurysms (one spontaneous and one iatrogenic); one patient (50%) died. Cranial nerve morbidity occurred in five cases (20.8%). Mean follow-up was 96.7 +/- 88.15 months (range 4 to 240 months) and included 2 of 7 (28%) complications in saphenous vein grafts, 1 (4.1%) late transient ischemic attack, and a recurrent aneurysm after 19 years.Symptoms and potential complications caused by EICAA suggest a broad surgical indication. EICAA can be treated safely because of the good early and long-term results.
Databáze: OpenAIRE
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