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Extracranial Internal Carotid Artery Aneurysm in a Patient with Marfan Syndrome
George S Sfyroeras1, Eleni Aliki Nikolopoulou1, Konstantinos G Moulakakis1
1Department of Vascular Surgery, University of Athens Medical School, Attikon University Hospital, Athens, Greece.
Abstract:
Extracranial internal carotid artery (ICA) aneurysms are rare and most of them are considered of atherosclerotic etiology. Marfan syndrome (MS) is a systemic connective tissue disorder caused by mutation in the extracellular matrix protein fibrillin 1. Clinical manifestations of the MS include aortic aneurysms, dislocation of the ocular lens, and long bone overgrowth. The presence of extracranial ICA aneurysm in patients with MS is very rare. We report a 62-year-old female patient with MS presented with an extracranial ICA aneurysm. She was treated with aneurysmectomy and end-to-end anastomosis, with good outcomes. Only 10 cases of patients with MS and extracranial ICA aneurysm have been described in the literature. Clinical presentation, treatment, and outcome of these patients are reviewed and discussed.
Insights
Extracranial internal carotid artery (ICA) aneurysms are rare, especially in Marfan syndrome (MS). This case report details a successful surgical treatment for MS-associated extracranial ICA aneurysm, adding to limited literature.
Area of Science:
- Vascular Surgery
- Genetics
- Connective Tissue Disorders
Background:
- Extracranial internal carotid artery (ICA) aneurysms are uncommon, typically linked to atherosclerosis.
- Marfan syndrome (MS) is a genetic disorder affecting connective tissue, primarily due to fibrillin-1 mutations.
- MS commonly presents with aortic aneurysms, lens dislocation, and skeletal overgrowth.
Observation:
- A 62-year-old female patient with known Marfan syndrome presented with an extracranial ICA aneurysm.
- This specific combination of Marfan syndrome and extracranial ICA aneurysm is exceptionally rare in medical literature.
- Only 10 previous cases of Marfan syndrome with extracranial ICA aneurysms have been documented.
Findings:
- The patient underwent successful surgical intervention, including aneurysmectomy and end-to-end anastomosis.
- The surgical outcome was favorable, indicating the viability of this treatment approach.
- This case contributes to the understanding of rare vascular manifestations in Marfan syndrome.
Implications:
- Highlights the importance of considering rare vascular pathologies in patients with connective tissue disorders like Marfan syndrome.
- Suggests that surgical repair, such as aneurysmectomy and anastomosis, can be effective for extracranial ICA aneurysms in MS patients.
- Emphasizes the need for further research and case reporting to better comprehend and manage these infrequent presentations.
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