A 65 year old woman was referred with an asymptomatic left carotid bruit. She had arterial hypertension, hypercholesterolaemia, and had stopped smoking five years previously. Her left carotid pulse was increased. Computed tomography angiography revealed a 15 mm saccular aneurysm of the elongated left extracranial internal carotid artery (ICA) without thrombus or stenosis (left image). Under general anaesthesia, she underwent aneurysmectomy with direct end to end anastomosis using a running monofilament polypropylene suture (right image), with no post-operative complications. After 18 months of follow up, she remains asymptomatic, with a normal duplex scan. Even if endovascular treatment may be an alternative, open surgery remains the best option in cases such as this with ICA tortuosity and endovascular access issues, thrombus burden, compression related symptoms, or infection.
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Publication history
Published online: December 01, 2022
Accepted:
November 23,
2022
Received in revised form:
November 16,
2022
Received:
November 4,
2022
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© 2022 The Author(s). Published by Elsevier Ltd on behalf of European Society for Vascular Surgery.
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