Open Repair of Two Ipsilateral Extracranial Internal Carotid Artery Aneurysms
Introduction: A patient with two ipsilateral extracranial internal carotid artery (ICA) aneurysms treated by open repair is reported, with an emphasis on pre-operative planning and decision making, and a review of literature. Report: A 44 year old man was diagnosed with a right thyroid lobe nodule a...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-01-01
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| Series: | EJVES Vascular Forum |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666688X20300277 |
| _version_ | 1819057493855174656 |
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| author | Iris G. Iflé Guus W. van Lammeren Willem E. van Prooijen André A.E.A. de Smet |
| author_facet | Iris G. Iflé Guus W. van Lammeren Willem E. van Prooijen André A.E.A. de Smet |
| author_sort | Iris G. Iflé |
| collection | DOAJ |
| description | Introduction: A patient with two ipsilateral extracranial internal carotid artery (ICA) aneurysms treated by open repair is reported, with an emphasis on pre-operative planning and decision making, and a review of literature. Report: A 44 year old man was diagnosed with a right thyroid lobe nodule and two asymptomatic ipsilateral aneurysms of the right ICA. Diagnostic workup using three dimensional reconstruction and centre lumen line measurements on computed tomography revealed two aneurysms of the right ICA, both > 20 mm. Surgery was planned with intra-operative mandibular subluxation to maximise distal exposure. Neuromonitoring consisted of transcranial Doppler ultrasound and electroencephalography. After mandibular subluxation and complete dissection of the aneurysms and digastric muscle division, adequate exposure of the distal ICA was obtained, followed by resection of both aneurysms, and reconstruction with a reversed greater saphenous vein graft. No complications occurred and one year follow up showed a patent graft without signs of stenosis or anastomotic aneurysm. Discussion: Open repair of two ipsilateral extracranial ICA aneurysms can be performed safely after careful pre-operative planning using visualisation of the vascular anatomy and distance measurements, and maximising exposure with digastric muscle division, styloidectomy, if necessary, and mandibular subluxation. |
| first_indexed | 2024-12-21T13:40:11Z |
| format | Article |
| id | doaj.art-53bdafc43c244215b695ea89e8845d4f |
| institution | Directory Open Access Journal |
| issn | 2666-688X |
| language | English |
| last_indexed | 2024-12-21T13:40:11Z |
| publishDate | 2020-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EJVES Vascular Forum |
| spelling | doaj.art-53bdafc43c244215b695ea89e8845d4f2022-12-21T19:02:02ZengElsevierEJVES Vascular Forum2666-688X2020-01-0148811Open Repair of Two Ipsilateral Extracranial Internal Carotid Artery AneurysmsIris G. Iflé0Guus W. van Lammeren1Willem E. van Prooijen2André A.E.A. de Smet3Maasstad Hospital, Department of Vascular Surgery, Rotterdam, The NetherlandsMaasstad Hospital, Department of Vascular Surgery, Rotterdam, The NetherlandsMaasstad Hospital, Department of Oral and Maxillofacial Surgery, Rotterdam, The NetherlandsMaasstad Hospital, Department of Vascular Surgery, Rotterdam, The Netherlands; Corresponding author. Maasstad Hospital Rotterdam, Maasstadweg 21, 3079 DZ Rotterdam, The Netherlands.Introduction: A patient with two ipsilateral extracranial internal carotid artery (ICA) aneurysms treated by open repair is reported, with an emphasis on pre-operative planning and decision making, and a review of literature. Report: A 44 year old man was diagnosed with a right thyroid lobe nodule and two asymptomatic ipsilateral aneurysms of the right ICA. Diagnostic workup using three dimensional reconstruction and centre lumen line measurements on computed tomography revealed two aneurysms of the right ICA, both > 20 mm. Surgery was planned with intra-operative mandibular subluxation to maximise distal exposure. Neuromonitoring consisted of transcranial Doppler ultrasound and electroencephalography. After mandibular subluxation and complete dissection of the aneurysms and digastric muscle division, adequate exposure of the distal ICA was obtained, followed by resection of both aneurysms, and reconstruction with a reversed greater saphenous vein graft. No complications occurred and one year follow up showed a patent graft without signs of stenosis or anastomotic aneurysm. Discussion: Open repair of two ipsilateral extracranial ICA aneurysms can be performed safely after careful pre-operative planning using visualisation of the vascular anatomy and distance measurements, and maximising exposure with digastric muscle division, styloidectomy, if necessary, and mandibular subluxation.http://www.sciencedirect.com/science/article/pii/S2666688X20300277AneurysmCarotidExtracranialMandibular subluxationOpen surgerySurgical planning |
| spellingShingle | Iris G. Iflé Guus W. van Lammeren Willem E. van Prooijen André A.E.A. de Smet Open Repair of Two Ipsilateral Extracranial Internal Carotid Artery Aneurysms EJVES Vascular Forum Aneurysm Carotid Extracranial Mandibular subluxation Open surgery Surgical planning |
| title | Open Repair of Two Ipsilateral Extracranial Internal Carotid Artery Aneurysms |
| title_full | Open Repair of Two Ipsilateral Extracranial Internal Carotid Artery Aneurysms |
| title_fullStr | Open Repair of Two Ipsilateral Extracranial Internal Carotid Artery Aneurysms |
| title_full_unstemmed | Open Repair of Two Ipsilateral Extracranial Internal Carotid Artery Aneurysms |
| title_short | Open Repair of Two Ipsilateral Extracranial Internal Carotid Artery Aneurysms |
| title_sort | open repair of two ipsilateral extracranial internal carotid artery aneurysms |
| topic | Aneurysm Carotid Extracranial Mandibular subluxation Open surgery Surgical planning |
| url | http://www.sciencedirect.com/science/article/pii/S2666688X20300277 |
| work_keys_str_mv | AT irisgifle openrepairoftwoipsilateralextracranialinternalcarotidarteryaneurysms AT guuswvanlammeren openrepairoftwoipsilateralextracranialinternalcarotidarteryaneurysms AT willemevanprooijen openrepairoftwoipsilateralextracranialinternalcarotidarteryaneurysms AT andreaeadesmet openrepairoftwoipsilateralextracranialinternalcarotidarteryaneurysms |