Carotid Artery Aneurysms

Abstract

Aneurysms of the extracranial portion of the carotid artery (CAAs) are an uncommon but important clinical entity. If untreated, they can lead to severe neurologic sequelae, including stroke from embolization of the aneurysm contents or even death from aneurysm rupture. Once diagnosed, decisions regarding their appropriate management can be complex due to the rarity of the condition, the multiple etiologies and anatomic configurations, and the variety of choices with regard to either open vascular surgical or endovascular repair techniques. This review defines the disease and covers the epidemiology, diagnosis, management, and outcome and complications of treatment of CAAs. Tables draw on the literature to showcase demographic information of patients undergoing surgery for CAAs, types of CAAs and prevalence of preoperative neurologic symptoms, types of surgical reconstruction performed for CAAs and perioperative outcomes, and long-term outcome following CAA surgery. Examples of endovascular techniques that may be use for treating CAAs are also provided. Figures show a pulsatile neck mass, a large CAA on physical examination, magnetic resonance angiography of CAA, the intraoperative appearance of CAA, and a morphologic classification system. This review contains 5 figures, 5 tables, and 57 references.