Extracranial carotid artery aneurysms (ECAA) are a rare cause of embolic stroke. The underlying etiology is variable, with atherosclerosis being the most common entity in older subjects. Several treatments have been developed over the last 20 years, but the preferred method remains unknown. Notwithstanding the widespread use of endovascular techniques, surgical reconstruction by means of a bifurcated venous bypass graft should be applied in younger patients. In this way, it is possible to avoid major concerns about the development of long-term intrastent restenosis, and also to spare the external carotid artery which represents the main branch for the ipsilateral cerebral and facial perfusion. We propose ECAA resection and interposition of the inverted great saphenous vein to both the internal and external carotid artery by means the use of a tributary, i.e., the Giacomini vein.

A Rare Cause of Juvenile Stroke: Extracranial Carotid Artery Aneurysm with Venous Complete Reconstruction of the Carotid Bifurcation / M. Domanin, S. Lanfranconi, S. Romagnoli, L. Runza, F. Cortini, G.P. Comi, L. Gabrielli. - In: PEDIATRIC NEUROSURGERY. - ISSN 1016-2291. - 53:4(2018), pp. 275-279. [10.1159/000487089]

A Rare Cause of Juvenile Stroke: Extracranial Carotid Artery Aneurysm with Venous Complete Reconstruction of the Carotid Bifurcation

M. Domanin
Primo
;
S. Lanfranconi
Secondo
;
S. Romagnoli;F. Cortini;L. Gabrielli
Ultimo
2018

Abstract

Extracranial carotid artery aneurysms (ECAA) are a rare cause of embolic stroke. The underlying etiology is variable, with atherosclerosis being the most common entity in older subjects. Several treatments have been developed over the last 20 years, but the preferred method remains unknown. Notwithstanding the widespread use of endovascular techniques, surgical reconstruction by means of a bifurcated venous bypass graft should be applied in younger patients. In this way, it is possible to avoid major concerns about the development of long-term intrastent restenosis, and also to spare the external carotid artery which represents the main branch for the ipsilateral cerebral and facial perfusion. We propose ECAA resection and interposition of the inverted great saphenous vein to both the internal and external carotid artery by means the use of a tributary, i.e., the Giacomini vein.
Carotid bifurcation reconstruction; Extracranial carotid artery aneurysm; Stroke; Adolescent; Aneurysm; Angiography; Carotid Artery Diseases; Humans; Male; Middle Cerebral Artery; Reconstructive Surgical Procedures; Saphenous Vein; Seizures; Stroke; Treatment Outcome; Vascular Surgical Procedures; Carotid Artery, External
Settore MED/22 - Chirurgia Vascolare
Settore MED/26 - Neurologia
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/598496
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