Dissection, Arteriosclerosis, Aneurysms, Treatment effects, Surgery, Decision analysis, Ultrasound, CT-Angiography, CT, Vascular, Cardiovascular system, Arteries / Aorta
M. Vishniakova , M. Vishnyakova, R. Lar'kov, S. Lunina, S. Zagarov, Y. Kolesnikov; Moscow/RU
In our study 9 patients had aneurysm of the internal carotid artery.
Aneurysm of the common carotid artery was observed in one case. All aneurysms had a saccular shape.
We divided patients in our study in 2 groups according to the state of aneurysm walls.
Thus signs of complicated course were observed in 6 patients (60% of cases).
Uncomplicated course of extracranial carotid aneurysm (4 cases)
Patients in this group had complaints of high blood pressure (3 patients) and ischemic stroke (1 patient).
Uncomplicated aneurysms of the carotid arteries were characterized by smooth and distinct contours,
good differentiation of the aneurysm from surrounding soft tissues Fig. 1 .
Complicated course of carotid aneurysms (6 cases)
These changes were represented by local deformation of aneurysm walls,
aneurysm dissection or false aneurysm.
Factors that influenced formation of complicated course were radiation therapy (1 patient) and post-traumatic changes (1 patient).
In other cases (4 patients) no such factors were identified.
False aneurysms were characterized by low differentiation of the aneurysm external contours from surrounding soft tissues Fig. 2 .
Optimal contrast enhancement of the adjacent structures was achieved in the venous contrast phase.
Dissecting aneurysm of the carotid arteries were characterized by formation of true and false lumens.
In our study no
In both groups (uncomplicated and complicated) in most cases aneurysms were associated with another carotid pathology - in 6 cases dolichoarteriopathies Fig. 3 and in 1 case severe stenosis were observed.
In 3 of 10 patients,
no aneurysm was detected by precise ultrasound examination due to its location in the uppermost sections of the internal carotid artery cervical segment.
From both groups 7 patients underwent surgical reconstruction. All findings concerning the state of aneurysms walls and lumen detected during CTA were confirmed during surgery Fig. 3 Fig. 4 .