Aneurysm Of Common Carotid Artery Research Articles

Uncommon Cause of Mass in the Neck-Giant Common Carotid Artery Aneurysm.

Uncommon Cause of Mass in the Neck-Giant Common Carotid Artery Aneurysm.

Primary common carotid artery aneurysm

A 63-year-old man, who had never smoked, had initially presented with a pulsatile right neck mass. He had no known connective tissue disorders or family history of aneurysm disease. He denied any history of neurologic deficits, transient ischemic attacks, or strokes. Computed tomography angiography demonstrated a 3.7-cm right common carotid artery aneurysm extending from the innominate bifurcation to the carotid bifurcation (Cover). A significant thrombus burden was present in the carotid artery aneurysm with diminished filling in the right internal, external carotid, and middle cerebral arteries (A and B).

Retracted: Endovascular Intervention in a Narrowing Vessel of the Left Vertebral Artery with Bilateral Common Carotid Artery Occlusion and Aneurysm Rupture and Hemorrhage in the V4 Segment of the Right Vertebral Artery.

[This retracts the article DOI: 10.1155/2022/3279090.].

Endovascular Intervention in a Narrowing Vessel of the Left Vertebral Artery with Bilateral Common Carotid Artery Occlusion and Aneurysm Rupture and Hemorrhage in the V4 Segment of the Right Vertebral Artery.

In this study, a case of bilateral common carotid artery occlusion and aneurysm in the V4 segment of the right vertebral artery with constriction of the left vertebral artery is presented. By improving digital subtraction angiography, an elderly female patient with subarachnoid haemorrhage (SAH) was diagnosed with a V4 segment of right vertebral artery aneurysm, a microaneurysm at the beginning of basilar aneurysms, bilateral common carotid artery occlusion, and narrowing vessel of left vertebral artery (DSA). Through the compensation of the basilar artery, the bilateral vertebral arteries provide intracranial and extracranial blood. Because the vertebral artery is narrowed, the right vertebral artery has priority in intracranial and extracranial blood delivery. Many members of the patient's immediate family have vasculitis, which has yet to be proven by appropriate laboratory testing but is thought to be the major cause of big artery occlusion. After cerebral angiography, the major source of this subarachnoid haemorrhage was determined to be a V4 segment of right vertebral artery aneurysm. Endovascular stent-assisted coil embolization was used to treat a V4 section of the right vertebral artery aneurysm. Because the basilar aneurysm was distal to the artery, interventional embolization was difficult to do, and it was not the major cause of the subarachnoid haemorrhage, the patient was advised to have follow-up surveillance, and she recovered well following the procedure. The combination of endovascular intervention of bilateral common carotid artery blockage and V4 segment of right vertebral artery aneurysm yielded excellent clinical outcomes in this instance. Endovascular treatment of a bilateral common carotid artery blockage paired with a V4 segment of a right vertebral artery aneurysm yielded excellent clinical outcomes in this patient, although long-term follow-up is necessary.

Giant carotid aneurysm in takayasu arteritis

Takayasu arteritis is an arteritis of unknown etiology, resulting in stenosis or dilatation of the aorta and its major branches. We report a rare case of a giant right common carotid artery aneurysm on the one side in a 29-year-old young male with refractory hypertension with severely stenotic, diffusely diseased, corkscrew appearance of the contralateral carotid artery, which has not been described in the literature so far. Our case is a unique demonstration of nature's paradox in vascular behavior in Takayasu arteritis in the right and left carotid arteries in an index patient; one having a giant aneurysm and the other one being severely stenotic, diffusely diseased with corkscrew appearance.

Stent-assisted Coil Embolization of a Common Carotid Artery Aneurysm Located Proximal to the Aortic Arch

Stent-assisted Coil Embolization of a Common Carotid Artery Aneurysm Located Proximal to the Aortic Arch

Rupture of a Common Carotid Artery Aneurysm

A 72 year old man presented to the emergency department with sudden onset of pulsatile mass in the right neck. The neurological examination noted decreased strength of the left upper and lower extremities. (A, B) Computerised tomography angiography showed contained rupture of a right common carotid artery aneurysm with a large right neck haematoma (arrow) and associated tracheal deviation (arrowhead). The patient was taken to the operating room urgently to repair the aneurysm with an interposition femoral vein graft. Post-operatively, his neurological examination was similar, and the patient was discharged to a rehabilitation facility.Image 1

Activated Platelet-Homing Nanoplatform for Targeting Magnetic Resonance Imaging of Aneurysm-Related Thrombus in Rabbits.

Thrombosis is closely related to the instability of intracranial aneurysm (IA), whose rupture is associated with high morbidity and mortality. It is difficult to detect an IA-related thrombus because traditional magnetic resonance imaging (MRI) and even contrast-enhanced MRI cannot clearly distinguish a thrombus from the surrounding tissues. Herein, a nanoplatform [(MFe2O4-ZnDPA nanoparticles (NPs)], consisting of Zn0.4Co0.6Fe2O4@Zn0.4Mn0.6Fe2O4 NPs for imaging and Zn(II)-bis(dipicolylamine) (ZnDPA) for thrombus targeting, is constructed to target an experimental aneurysm-related thrombus in rabbits via MRI. In vitro experiments including platelet safety evaluation primarily prove that MFe2O4-ZnDPA NPs with a high MRI transverse relaxation time (T2) have good biocompatibility. MFe2O4-ZnDPA NPs could target a thrombus via the special interaction between ZnDPA and phosphatidylserine of activated platelets in the thrombus through MRI and Fe quantification assays. Moreover, after MFe2O4-ZnDPA NPs are injected into the ear vein of common carotid artery aneurysm model rabbits, MRI shows that MFe2O4-ZnDPA NPs could accumulate in the aneurysm-related thrombus from 0 to 15 min after injection and decrease in the next 45 min. Meanwhile, MFe2O4-ZnDPA NPs could decrease the MRI T2 signal of the aneurysm-related thrombus to enhance the outline of the aneurysm. This study demonstrates that a nanoplatform can enhance the detection of an aneurysm-related thrombus as well as aneurysm itself to assist further treatment of IA.

Surgical Repair of Complex Distal Internal Common Carotid Artery Aneurysm

<h3>Introduction</h3> Carotid artery aneurysms are a rare occurrence with potentially severe complications including neurological symptoms from embolization and rarely rupture. They comprise between 0.4%-4% of all peripheral aneurysms and are between 0.1%-3.7% of carotid procedures at major centers. The following is a discussion of one such procedure for a complex right common carotid with distal extension into the internal carotid artery. <h3>Methods/Results</h3> Patient was a 64-year-old male with incidental finding of right common and internal carotid artery aneurysm and occlusion of the contralateral side seen on Computer Tomography scan. Based on the patient's age and anatomy the decision was made to proceed with an open repair of the aneurysm. Due to the distal location of the internal catrotid aneurysm adequate exposure was achieved using general nasotracheal anesthesia and ligation of the occipital artery. The oral maxillofacial surgeon was on standby for possible mandible dissection; however, this was unnecessary. The reconstruction was performed using reversed femoral vein. An Argyle shunt was used to bypass the aneurysm to maintain blood flow through the internal carotid artery. An ulcerated region of the aneurysm was resected and the distal and proximal anastomosises were created. The external carotid artery was then ligated and a carotid duplex ultrasound performed intraoperatively revealed satisfactory endpoints and no evidence of significant stenosis. Upon awakening the patient, a brief neurological exam showed no deficits.Figure 1CTA of AneurysmFigure 1Figure 23D Reconstruction of CTFigure 2Figure 3Intraoperative Image Prior to BypassFigure 3Figure 4Intraoperative Image After BypassFigure 4Figure 5Follow Up Ultrasound at 4 WeeksFigure 5 Intraoperative cerebral oximetry and neuromonitoring were used throughout the procedure. Immediately post-operation the patient had transient hypoparesis which had resolved at 4 week follow up. <h3>Conclusion</h3> Carotid artery aneurysms, although rare, have a mortality rate up to 70% and a stroke rate greater than 50%; therefore, surgical intervention is the treatment of choice, with open intervention being the most common. This case demonstrates that even with an occluded contralateral carotid artery and a complex aneurysm with distal extension, carotid bypass can be done safely using stents and adequate neuromonitoring.

TCTAP C-086 Kissing “Y” Stents to Exclude a Large Right Common Carotid Artery Aneurysm in a Case of Takayasu Arteritis

TCTAP C-086 Kissing “Y” Stents to Exclude a Large Right Common Carotid Artery Aneurysm in a Case of Takayasu Arteritis

An Effective and Simple Way to Establish Elastase-Induced Middle Carotid Artery Fusiform Aneurysms in Rabbits.

Objective Elastase-induced aneurysms in rabbits have been proposed as a preclinical tool for device development, but there is still much deficiency in those aneurismal models. So we need to explore the efficient and convenient animal models for the investigation of intracranial aneurysms. Then, we compared and analyzed three methods of elastase-induced carotid artery aneurysms in rabbits and aimed to find a simple, effective, and reproducible method for creating elastase-induced aneurysms. Methods 42 standard feeding male adult Japanese white rabbits (3.05 ± 0.65 kg) were randomly divided into 3 groups and treated with elastase ablation to create common carotid artery (RCCA) aneurysm models: Group A (root-RCCA medication group, n = 12), Group B (mid-RCCA medication group, n = 18), and Group C (ligated RCCA+medication group, n = 12). For Group A, the origin of the RCCA was blocked by two temporary aneurysm clips, and the resulting 2 cm cavity was infused with elastase for 20 min, then the clip was removed and the RCCA was not ligated. For Group B, the middle part of RCCA was treated the same way as Group A and the RCCA was not ligated. For Group C, the middle part of RCCA was treated as Group B, but the distal RCCA was ligated. After the aneurysm models were created for 3 weeks, prior to sacrificing the animals, color Doppler ultrasound and angiography were performed for blood flow measurements inside the aneurysms. Histological analysis (such as SMA-α, CD31, CD34, CD68, collagen IV, and Ki67) and the other relevant indexes were compared between the ideal model's aneurysmal tissues and the human intracranial aneurysm's tissues to confirm whether we have successfully established elastase-induced aneurysm models. Results Compared with human intracranial aneurysm specimens by the color Doppler ultrasound, angiography, and changes in the inner diameter of arteries, all three methods have successfully established the elastase-induced aneurysm models. Histology showed that biological responses were similar to both human cerebral aneurysms and previously published elastase-induced rabbit aneurysm models. Group A and Group B had the same morphology, but Group A had a higher mortality rate than Group B. Group B and Group C had different morphology. The aneurysm of Group C was more similar to human cerebral aneurysms but had a higher mortality rate than Group B. Group B was confirmed not only as an alternative method but also as a more safe and effective method for creating elastase-induced aneurysm models. Conclusion Through analysis and comparison, the Group B is proven to be the simplest, reproducible, and most effective modeling method. The aneurysm model established by Group B can be used for basic research related to aneurysm mechanism. We have provided a new and effective method for basic research on aneurysm.

Case of Mycotic Pseudoaneurysm of the Common Carotid Artery due to Salmonella typhi Bacteremia

Aneurysm of the extracranial carotid artery is a rare disease, mycotic pseudoaneurysms being even less common. They are a life-threatening complication of systemic infection and atherosclerosis. Immunocompromised people, including patients with HIV, uncontrolled diabetes melltus, those on immunosuppressants like high-dose steroids, and chemotherapy, are at a higher risk for development of mycotic pseudoaneurysms. Due to the high risk of potential complications like rupture and thromboembolic events, mycotic aneurysms always require surgical management. Early detection followed by restoration of blood flow is critical to minimize a fatal outcome. Here we report the case of a 52-year-old man with a past history of hypertension and dyslipidemia who presented with a pulsatile painful neck swelling. On evaluation, the patient was diagnosed to have Salmonella typhi bacteremia, HIV infection, and a mycotic aneurysm of the left common carotid artery.

A Case of Mycotic Common Carotid Artery Aneurysm That Needed Retreatment after Carotid Artery Stenting

A Case of Mycotic Common Carotid Artery Aneurysm That Needed Retreatment after Carotid Artery Stenting

Endovascular Treatment of Common Carotid Artery Aneurysm - Case Report and Review of Current Literature

Endovascular Treatment of Common Carotid Artery Aneurysm - Case Report and Review of Current Literature

Surgical repair of common carotid artery aneurysm insix years after carotid endarterectomy

Surgical repair of common carotid artery aneurysm as an extremely rare complication of carotid endarterectomy in long-term period is described. Aneurysmectomywasfollowed by patch repair of the artery. It was concluded that this intervention is effective approach for this complication. The main causes of this adverse event are identified.

Natural history of aneurysmal aortic arch branch vessels in a single tertiary referral center

ObjectiveLittle is known about the natural history and management of aneurysmal aortic arch branch vessels (AABVs). The objectives of this study were to assess the natural history of aneurysmal AABVs and to examine the outcomes of operative intervention. MethodsA retrospective review of the Yale radiologic database from 1999 to 2016 was performed. Only those patients with an aneurysmal AABV and a computed tomography scan were selected for review. Patients' demographics, aneurysm characteristics, management, and follow-up information were collected. ResultsThere were 105 patients with 147 aneurysmal AABVs; 76 were male (72%), with a mean age of 70 years (range, 17-93 years). We identified 63 innominate, 50 left subclavian, 30 right subclavian, and 4 common carotid artery aneurysms. On computed tomography, 65 (62%) had aortic aneurysms and six (6%) had suffered an aortic dissection. Most were asymptomatic (104 [99%]); one had chest pain and an enlarging swollen mass. Twelve (11%) patients underwent operative repair (OR) for 12 aneurysmal AABVs because of symptoms, growth, or concomitant aortic operations; 93 (89%) were observed in the no operative repair (NOR) group with cross-sectional imaging. The overall mean vessel diameter was 2.08 ± 0.68 cm. The mean diameters in the OR and NOR groups were 3.32 ± 1.24 cm and 1.97 ± 0.46 cm, respectively (P = .002). OR included nine bypasses with resection, two stent grafts, and one resection without reconstruction. Two patients developed postoperative hemorrhage requiring re-exploration, one patient developed stent thrombosis, and one patient required pseudoaneurysm repair 20 years after index operation. Mean follow-up was 52 ± 51 months for the NOR group, with no ruptures or emboli. The growth rate was 0.04 ± 0.10 cm/y. On multivariable regression analysis, a descending aortic aneurysm (P = .041) and a left subclavian artery aneurysm (P = .016) were associated with higher growth rates, whereas height was associated with a lower growth rate (P = .001). ConclusionsAneurysmal AABVs tend to have a benign natural history with slow growth rates and low rates of complications, including rupture and embolization. We recommend expectant observational management for small, incidentally detected aneurysms.

Natural History of Aneurysmal Aortic Arch Branch Vessels in a Single Tertiary Referral Center

Little is known about the natural history and management of aneurysmal aortic arch branch vessels (AARBVs). The objectives of this study were to assess the natural history of AARBVs and the AARBV’s risk of rupture and to examine the outcomes of operative intervention. A retrospective review of the Yale radiologic database from 1999 to 2016 was performed. Only those patients with AARBV and a computed tomography scan were selected for review. Patient demographics, aneurysm characteristics, management, and follow-up information were collected. There were 111 patients with 153 AARBVs identified; 79 were male (71%), with mean age of 70 years (range, 17-93 years). There were 65 brachiocephalic, 51 left subclavian, 33 right subclavian, and 4 common carotid artery aneurysms. On computed tomography, 68 (61%) had aortic aneurysms, 32 (29%) bovine arch, and 8 (7%) aortic dissections. Most were asymptomatic (105 [95%]); four had arm pain and one had chest pain, shortness of breath, and dysphagia, respectively. One patient presented with a ruptured brachiocephalic pseudoaneurysm (size, 6.5 cm). Nineteen (17%) patients underwent operative repair (OR); 92 (83%) were followed up with cross-sectional imaging (NOR). The overall mean vessel diameter was 2.22 ± 0.96 cm. The diameter of OR and NOR was 3.94 ± 1.61 cm and 1.97 ± 0.46 cm, respectively (P < .00001). OR included 13 bypasses, 5 stent grafts, and 1 resection without reconstruction. Two patients developed postoperative hemorrhage requiring re-exploration. One patient required pseudoaneurysm repair 20 years after index operation. Mean follow-up was 52 ± 51 months for NOR without any ruptures. Four patients underwent elective repair of AARBV because of either growth or other aortic operation. The growth rate was 0.04 ± 0.10 cm/y. On multivariable regression analysis, age (P = .011), the presence of ascending (P = .011) or descending aortic aneurysms (P =.005), and a left subclavian artery aneurysm (P = .038) were associated with higher growth rates, whereas height was associated with a lower growth rate (P = .0005). Few patients with AARBVs require an operation. Operative intervention is safe and has a low index of complications. In the presence of other aortic abnormalities, open repair would be favored. When feasible, an endovascular option can be pursued. Given that we observed no true AARBV rupture, patients can be observed safely with imaging, accepting a growth rate of 0.04 ± 0.10 cm/y.

Surgical treatment of a spontaneous rupture of a giant common carotid artery aneurysm

Primary atherosclerotic aneurysms of the carotid artery are extremely are. Most cases are due to atherosclerotic disease, pseudoaneurysms secondary to neck trauma or previous surgery and mycotic aneurysms. Vascular surgeons will very likely encounter only 2 or 3 of these aneurysms in their professional life as surgeons. Although rare, these aneurysms pose a significant risk to the patient, due to embolisation of the thrombus, neurological complications, compression of adjacent neck structures and, more rarely, rupture from infection and previous surgery. The following case report describes the presentation and surgical treatment of a spontaneously ruptured gigantic common carotid artery aneurysm. DOI: http://dx.doi.org/10.21615/cesmedicina.30.1.8

Overlapped Stenting for Treatment of an Extracranial Carotid Artery Aneurysm.

Extracranial carotid artery aneurysms (ECAAs) are rare, and their treatment is very difficult and challenging. The case of a 59-year-old woman who presented with a pulsatile mass on the left side of her neck, was diagnosed with a left-sided giant thrombosed common carotid artery aneurysm, and underwent definitive treatment by overlapped stenting, is presented. Overlapped stenting is a safe and an effective treatment procedure for ECAA. A covered stent would theoretically be reasonable and immediately effective, but its long-term patency remains unknown. Therefore, in patients lacking ischemic tolerance and those not requiring urgent intervention, overlapped stenting using uncovered stents is preferable.

Thoracic Endovascular Aortic Repair for Challenging Aortic Arch Diseases Using Fenestrated Stent Grafts From Zone 0

Although previous reports have described the repair of distal aortic arch aneurysms through debranching and chimney techniques, these methods invariably involve surgical management of the carotid artery. We report clinical results of thoracic endovascular aortic repair (TEVAR) using fenestrated stent grafts in the treatment of aortic arch aneurysms located less than 15 mm from the left common carotid artery. A semi-custom-made fenestrated stent graft designed to fit aortic arch tortuosity and preserve blood flow at least into the brachiocephalic and left common carotid arteries was placed from zone 0. From 2007 through 2013, TEVAR from zone 0 was performed on 37 high-risk patients for open surgery (mean age 78.2 years). The mean length between the left common carotid artery and aortic aneurysm was 11.1 mm (range, 5 to 15 mm). The left subclavian artery was preserved for 26 patients (70.3%) through surgical reconstruction (n = 19) and graft fenestration (n = 7). The early mortality rate was 0%. Postoperative strokes and spinal cord ischemia occurred in 2 (5.4%) and 3 (8.1%) patients, respectively. Although type I endoleaks at discharge were noted in 12 (32.4%) patients, aneurysm enlargement was noted during follow-up in 6 (16.2%). Four patients (10.8%) underwent secondary interventions consisting of 3 coil embolization procedures; 2 re-TEVARs and 1 open conversion. There were no aorta-related late deaths. Survival and aorta-related event-free rates at 2 years were 86.3% and 88.8%, respectively. Thoracic endovascular aortic repair using fenestrated stent graft from zone 0 can be considered as one of therapeutic options for high-risk patients with aortic arch diseases.