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03 July 2019 : Clinical Research  

Management of Extracranial Carotid Artery Aneurysms: A 6-Year Case Series

Zuoguan Chen12ABE, Lidan Chen23BE, Jun Zhang4B, Yuexin Chen25F, Changwei Liu25B, Yongpeng Diao12C, Yuqing Miao12D, Qing Gao12C, Yongjun Li12ADF*

DOI: 10.12659/MSM.914374

Med Sci Monit 2019; 25:4933-4940

Abstract

BACKGROUND: We discuss the presentation and management of extracranial carotid artery aneurysms (ECAAs) and to develop a new type of classification.

MATERIAL AND METHODS: A retrospective review of 35 ECAAs patients who were admitted in our institution from January 2010 to June 2016 was conducted. The mean follow-up period was 25.58±22.13 months.

RESULTS: During the study period, 35 aneurysms were diagnosed and treated (mean age, 50.8±15.6 years; 15 men). There were 28 true aneurysms, 5 false aneurysms, and 2 dissecting aneurysms. A total of 16 patients with true aneurysms underwent open surgical treatment (group 1), whereas 15 received endovascular management, including all false and dissecting aneurysms (group 2). The remaining 4 true aneurysms were treated with hybrid operation (group 3). The patency rates of groups 1, 2, and 3 were 100%, 93.3%, and 100%, respectively. According to the Peking Union Medical College Hospital (PUMCH) Classification, all 24 cases of type Ia aneurysms were treated by either open surgery and/or endovascular treatment, whereas all 3 type Ib cases were treated solely by open surgery. All 5 type IIa patients were treated by endovascular treatment, with the exception of 1 failure that was transferred to hybrid operation. All 3 type IIb patients were treated by hybrid operation.

CONCLUSIONS: Open surgery was more frequently feasible in true aneurysms, and endovascular surgery was the first choice for false and dissecting aneurysms. Hybrid operation was available for complicated cases. The PUMCH classification may be helpful for selection of management strategies for ECAAs.

Keywords: Aneurysm, Arteriovenous Shunt, Surgical, Carotid Artery Diseases, endovascular procedures, Two-Hybrid System Techniques, Aged, Aneurysm, Dissecting, Blood Vessel Prosthesis Implantation, Carotid Arteries, China, Middle Aged, Retrospective Studies, Treatment Outcome

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Editorial

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750