Abstract
Extracranial carotid artery aneurysms are very rare, but serious complications may result from these aneurysms such as emboli, thrombosis, or rupture. Various treatments for such aneurysms have been reported, including open surgery and endovascular surgery. However, large aneurysms which extend to the skull base can be difficult to treat using conventional methods. Case: A 50-year-old woman presented with a pulsatile mass in her right neck. The proximal side of the aneurysm was located near the origin of the internal carotid artery (ICA). Three fusiform aneurysms, measuring a maximum of 3.1 mm in diameter, were observed to be threaded through a narrow channel. The main aneurysm extended to the base of skull. An aneurysmectomy was not indicated because the distal ICA could not be controlled. We considered that an endovascular procedure could be performed because no mural thrombus existed, and the patient was classified as tolerable according to a Matas test. The aneurysm was successfully treated by distal coil embolization, proximal ligation and a partial resection. An aneurysmectomy with reconstruction has been the standard treatment for extracranial ICA aneurysms. However, some cases aneurysmectomy is not indicated, and therefore an alternative treatment option should be selected based on the size, location and type of aneurysm(s), as well as on the presence or absence of infection.
