Carotid ligation for carotid aneurysms
Insights
Common carotid artery ligation effectively treats ruptured carotid aneurysms, with delayed surgery reducing risks of cerebral ischemia. This method is valuable for managing subarachnoid hemorrhage.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Neurology
Background:
- Subarachnoid hemorrhage (SAH) from ruptured carotid aneurysms presents significant risks.
- Traditional treatments for such aneurysms carry potential complications.
Observation:
- Thirty patients with SAH due to ruptured carotid aneurysms underwent common carotid artery ligation.
- Post-operative complications included mortality (2/30) and persistent hemisphere deficit (2/30).
- Cerebral ischemia occurred in 8/10 patients operated within 10 days of bleeding.
Findings:
- Delayed ligation, performed at the end of the second week post-hemorrhage, aims to mitigate early ischemic complications.
- No recurrent hemorrhages were observed during a 1-8 year follow-up period.
- Common carotid ligation, especially with monitoring of end pressure, cerebral blood flow, and EEG, is effective.
Implications:
- Optimizing the timing of common carotid ligation is crucial for patient outcomes.
- This surgical approach offers a viable treatment for ruptured intracranial carotid aneurysms.
- Further research should focus on refining surgical timing and monitoring techniques to minimize neurological deficits.
Abstract:
Thirty patients with subarachnoid haemorrhage due to rupture of a carotid aneurysm were treated by ligation of the common carotid artery. Two patients died as a result of the procedure, two patients developed persisting hemisphere deficit. Eight of the ten patients who developed cerebral ischemia after the operation were operated within ten days after the bleeding. At present out aim is to guide the patient safely through the first ten days after his haemorrhage and perform ligation at the end of the second week. After a follow up period of 1-8 years recurrent haemorrhage did not occur. Common carotid ligation, preferably with control of carotid artery end pressure, cerebral blood-flow and EEG is considered to be a valuable method to treat ruptured intracranial carotid aneurysm.
