Objective:To discuss surgical treatment of carotid aneurysm.
Methods:The clinical data of 16 patients with carotid aneurysm treated in our department from August 2005 to May 2010 were retrospectively analyzed. The average interval from onset to hospitalization  was (31.0 ± 0.7) months. Of the patients, 15 cases were unilateral aneurysm and 1 case was bilateral aneurysm. The lesions were respectively located in common carotid artery (5 cases), internal carotid artery (9 cases) and external carotid artery (2 cases). The clinical findings of the patients included asymptomatic lesions in 7 cases, varying degrees of nerve compression in 5 cases and cervical mass after injury in 4 cases. All the patients underwent open surgery or endovascular treatment.
Results:One-stage operation was successfully performed in all patients that included 9 cases of surgical resection and 7 cases of endovascular therapy, and no operative death occurred. Eleven patients were followed up for an average period of (23.3 ± 0.7) months. Ultrasonic evaluation showed that all grafts were patent in the 5 cases undergoing great saphenous vein grafting; in the 4 other cases with placement of covered stents, the carotid arteries were patent and the aneurysms were completely occluded. In-stent thrombosis and carotid artery occlusion were detected in another 2 cases, but no further surgical treatment was performed because they caused no obvious symptoms.
Conclusions:The incidence of carotid aneurysm is relatively low, but it has high risk potential. Thus, it should be aggressively treated once diagnosed. Open surgery has obvious curative effect, while endovascular treatment is minimally invasive, and both procedures are effective treatments for carotid aneurysm.