Abstract
Extracranial internal carotid artery aneurysm (ECICA) is uncommon, but represents a challenging treatment strategy. We experienced a large size of ECICA (7 cm) concomitant with a high-grade of internal carotid artery (ICA) tortuosity. A 71-year-old female presented with discomfort of the throat. She had subarachronoidal hemorrhage at the age of 68, but made a full recovery of daily activities, after clipping of the ipsilateral intracranial ICA aneurysm and ventriculo-peritoneal shunt. Contrasted computer tomography revealed the ECICA on the tortuous ICA. After resection of aneurysm, the curved ICA was stretched distally. The distal stump was directly anastomosed to the proximal end of ICA. Ischemic complications or cranial nerve injury was not recognized postoperatively. Aneurysmectomy with arterial reconstruction has been an ideal treatment for such ECICA. In similar cases, concerning tortuosity of the ICA and the lack in long-term results, endovascular methods, including (covered) stent implantation or coil embolization, should be considered secondarily.
