Abstract
An 82-year-old woman was diagnosed with extracranial carotid artery aneurysms (ECAAs). These aneurysms were resected using the posterior cervical triangle. The patient had transient right paresis and a left cervical aneurysm, measuring a maximum diameter of 72.2 mm. Six years earlier, a left cervical aneurysm of 24.1 mm in diameter was detected but the patient was asymptomatic during follow-ups. Diffusion-weighted magnetic resonance imaging revealed a fresh cerebral infarction in the left frontal cortex. The surgical procedure consisted of a skin incision from the mastoid process along the anterior margin of the sternocleidomastoid muscle and an L-shaped incision extending outward over the clavicle from its lower edge. Proper field development during extracranial carotid artery aneurysm surgery and the selection of an appropriate surgical technique are both important. In this case, the internal jugular vein was riding on the outer wall of the aneurysm and was firmly attached to the surrounding tissues. Thus, an internal shunt was placed and an arteriotomy was performed. Although the intima was smooth and normal, the aneurysm was filled with organic thrombus. After dissecting the aneurysm from the surrounding tissues, the aneurysm was removed, and the normal vessel wall was sutured.
