Resection of an internal carotid artery aneurysm with extreme cranial exposure maneuvers

Abstract

A 63-year-old woman presented with an enlarging lump below the angle of her left mandible. Neck computed tomography angiography revealed a 5 × 3 cm left internal carotid artery (ICA) aneurysm, arising 3 cm cranial to the carotid bifurcation and extending to the top of the second cervical vertebral body (Supplementary Video 1, online only), and this was confirmed on cervical angiography (Supplementary Video 2, online only). Initially, two overlapping flow-diverting stents were deployed leading to stagnant flow within the aneurysm sac (Supplementary Video 2, online only).