Bilateral Extracranial Carotid Artery Aneurysms Treated by Staged Surgical Repair

Bilateral extracranial carotid artery aneurysms (ECAAs) are very rare. The case of a patient with bilateral ECAA who underwent staged surgical repair is reported.

A 35 year old man was referred with a slow growing pulsatile neck mass causing mild discomfort. Computed tomography and duplex ultrasound showed a right ECAA, with a 3.0 cm diameter 5 cm long true aneurysm, and a left ECAA, with 2.1 cm diameter 4.5 cm long true aneurysm. In two stages, both aneurysms were excised and bypassed with an interposition graft using saphenous vein.

ECAAs are rare with an incidence of about 4% of all peripheral aneurysms. Selection of treatment options is largely dependent on the aneurysm anatomy, including size and length. During open repair, it is important to avoid nerve injury.