Key result
Open excision and anastomosis for giant extracranial ICA aneurysm yields no neurological deficits at 1 month.
Why the study?
Extracranial internal carotid artery aneurysms are rare lesions with potential thromboembolic and compressive complications.
Case Report (n=1)
No
Demonstrates that open surgical excision with primary tension-free end-to-end anastomosis (leveraging arterial tortuosity) and careful vagus nerve preservation is feasible and safe for giant true extracranial internal carotid artery aneurysms.
Answers are grounded in this paper and cite their sources.
Demonstrates short-term safety of vagus-preserving open repair; leaves open durability and generalizability beyond single cases.
Extracranial internal carotid artery (ICA) aneurysms are rare lesions with potential thromboembolic and compressive complications. A 57-year-old woman presented with a painless, enlarging right-sided neck swelling of six months’ duration. Duplex ultrasonography identified a saccular ICA aneurysm without thrombus. Computed tomography angiography showed a 4.5 × 3.2 cm wide-necked aneurysm, 2.5 cm above the carotid bifurcation, with marked arterial tortuosity. Open aneurysm excision was selected. The vagus nerve was densely adherent to the posterior aneurysm wall and was carefully preserved; arterial continuity was restored by tension-free end-to-end anastomosis. Histopathology confirmed a true aneurysm with mucoid medial degeneration. Recovery was uncomplicated, without postoperative neurovascular complications or focal neurological deficits. At one-month follow-up, there were no neurological deficits or recurrent neck swelling. Postoperative CT angiography was reportedly performed, but images and findings require incorporation and verification. This case highlights individualized operative planning and cranial nerve preservation in selected extracranial ICA aneurysms.
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Dr. B Hayagriva Rao1, Dr. D Ravi2, Dr. Yaswanth3 (2026) conducted a case report in Giant true extracranial internal carotid artery aneurysm (n=1). Open aneurysm excision with vagus nerve preservation and tension-free end-to-end anastomosis was evaluated on Postoperative neurovascular complications, focal neurological deficits, or recurrent neck swelling. Open excision with end-to-end anastomosis and vagus nerve preservation for a 4.5x3.2 cm extracranial ICA aneurysm resulted in 0 neurological deficits or recurrence at 1-month follow-up.
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