Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.202501182
Jornal Vascular Brasileiro
Case Report

Open surgical repair of a loop-forming extracranial internal carotid artery aneurysm: a case report and literature review

Reparo cirúrgico aberto de aneurisma da artéria carótida interna extracraniana com formação em alça: relato de caso e revisão da literatura

Cigdem Tel Ustunisik; Omer Faruk Soydas; Lara Yagci; Berk Arapi; Ozan Onur Balkanay; Deniz Göksedef; Suat Nail Omeroglu

http://dx.doi.org/10.1590/1677-5449.202501182 J Vasc Bras, vol.25, e20250118, 2026
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Abstract

Extracranial carotid artery aneurysms (ECCA) are rare vascular lesions that may be asymptomatic or present with compression-related symptoms, depending on their size and location. Etiologies include trauma, congenital anomalies, inflammation, atherosclerosis, or prior interventions. Major complications involve cranial nerve compression, rupture, and cerebral thromboembolism. Diagnostic and therapeutic management can be challenging, with treatment options including conservative follow-up, endovascular intervention, or open surgery. We present the case of a 76-year-old woman admitted with visual disturbances and a palpable mass on the left side of her neck. Radiological imaging revealed a 2 cm aneurysm with loop formation in the left internal carotid artery. The aneurysm was treated with open surgical aneurysmectomy and end-to-end anastomosis without grafting. Postoperative recovery was uneventful. Open surgical repair remains a safe and effective treatment, particularly in anatomically complex cases in which endovascular techniques are not feasible due to arterial tortuosity.

Keywords

extracranial carotid artery aneurysm; open surgery; aneurysmectomy; vascular reconstruction; case report

Resumo

Os aneurismas da artéria carótida extracraniana são lesões vasculares raras que podem ser assintomáticas ou apresentar sintomas relacionados à compressão, dependendo do tamanho e da localização. As etiologias incluem trauma, anomalias congênitas, inflamação, aterosclerose ou intervenções prévias. As principais complicações envolvem compressão de nervos cranianos, ruptura e tromboembolismo cerebral. O diagnóstico e o manejo terapêutico podem ser desafiadores, e as opções de tratamento incluem acompanhamento conservador, intervenção endovascular ou cirurgia aberta. Apresentamos o caso de uma mulher de 76 anos, admitida com distúrbios visuais e massa palpável no lado esquerdo do pescoço. Os exames de imagem revelaram um aneurisma de 2 cm com formação em alça na artéria carótida interna esquerda. O aneurisma foi tratado por meio de aneurismectomia aberta com anastomose terminoterminal, sem uso de enxerto. A recuperação pós-operatória transcorreu sem intercorrências. A cirurgia aberta continua sendo uma opção segura e eficaz, especialmente em casos com anatomia complexa, nos quais as técnicas endovasculares não são viáveis devido à tortuosidade arterial.

Palavras-chave

aneurisma da artéria carótida extracraniana; cirurgia aberta; aneurismectomia; reconstrução vascular; relato de caso

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Submitted date:
08/29/2025

Accepted date:
02/16/2026

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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