Endovascular Treatment and Hybrid Surgery for Extracranial Internal Carotid Artery Aneurysms

Extracranial internal carotid artery aneurysms (EICAAs) are rare, and both endovascular treatment and hybrid surgery have been used to treat them. Herein, we evaluated the outcomes of endovascular treatment and hybrid surgery for EICAAs treated at our institution.

Twenty-eight patients diagnosed with EICAA and treated with endovascular treatment or hybrid surgery in our center from January 2013 to June 2023 were retrospectively reviewed. Clinical characteristics, aneurysm features, perioperative outcomes, and follow-up results were collected and analyzed.

A total of 28 patients with 30 EICAAs received endovascular treatment and hybrid surgery. The mean age of patients was 61.0 years, and 21 patients (75.0%) were male. Fifteen true aneurysms (50.0%) and 15 pseudoaneurysms (50.0%) were detected. Fifteen patients with 15 aneurysms received endovascular treatment and 13 patients with 15 aneurysms received hybrid surgery. The overall technical success rate was 90.0% (27/30). During the perioperative period, one patient (1/15, 6.7%) in the endovascular group experienced a minor stroke. The median follow-up duration was 17.5 months (range, 2-100 months). Excluding the patient who received carotid ligation during surgery, the overall patency rate was 93.1% (27/29) during the follow-up period. One patient (1/15, 6.7%) in the endovascular group experienced a minor ipsilateral stroke. Of the 29 patients with aneurysms receiving stent employment, one (1/29, 3.4%) underwent endovascular reintervention 12 months after the procedure because of severe restenosis.

Endovascular treatment and hybrid surgery are feasible options in the treatment of EICAAs that achieve satisfactory short-term results.