Interposition grafting of large extracranial carotid aneurysm

Extracranial carotid aneurysms are a rare entity and carry an inherent risk of thromboembolic complications. Treatment options consist of endovascular and conventional surgical techniques. We describe the cases of 3 patients who were treated with an interposition graft for a large extracranial carotid aneurysm.The patients had presented with an extracranial carotid aneurysm with a diameter of 30 to 43 mm. In all cases, the aneurysm was excluded by means of an interposition graft, without major perioperative complications. There was 1 case of temporary paresis of the facial nerve and another of temporary paresis of the vocal cord. After a mean follow-up period of 14 months, all patients were alive, and there were no neurologic deficits.A retrospective analysis was performed of patients who had undergone conventional surgical treatment of extracranial carotid aneurysms. The patients' characteristics, symptoms, surgical interventions, complications, and deaths were all documented.Carotid aneurysms can safely be excluded by interposition grafting, and this treatment should still be considered for most patients, although endovascular repair might provide a valid alternative.