Diagnosis and therapy for an extracranial carotid aneurysm

To describe the diagnostic means and therapy employed in three cases of extracranial carotid aneurysms.

Retrospective analysis of three cases.

For the diagnosis we obtained real-time pictures of each aneurysm by color Doppler ultrasonography before the angiography. Based on the result of cerebral collateral flow evaluation, ligation of both ends of the aneurysm was performed in one case, embolization of the artery in another, and resection of the aneurysm in the other; vascular reconstruction was not necessary. Although a carotid artery balloon occlusion test must be done before the operation, color Doppler ultrasonography and/or a transcranial color Doppler-guided Matas' test were performed instead, because these patients needed immediate management.

The diagnostic procedures were very useful to decide what action to take in such urgent cases.