Case study
Case
 16 years male presented with
complaints of dizziness associated
with transient loss of vision ? in the
right eye ov...
Diagnosis ?
History ?
 Any neurological deficit
 Trauma
 Any surgery
 Fever, joint pain ?
Examination ?
 Swelling
 Pulsatile mass
 Oral cavity
 Carotid bruit
 Horner’s syndrome
Complication ?
 Thromboembolism
 Neurological complications
 Rupture
Management ?
 Surgical reconstruction
 Endovascular treatment
Complication ?
 Thrombosis
 Endoleak
 Perforation
 Migration
 Infection
 Dissection of artery
Carotid Artery Aneurysm
Introduction
 Aneurysm of extracranial carotid
artery (ECAA) is an uncommon but
important clinical entity
 Incidence of ...
Definition
 The accepted difinition of most
arterial aneurysm is 50 % increase
in diameter compared to the normal
diamete...
Etiology
 Degenerative / Atherosclerosis
 Post traumatic causes
 Postendarterectomy
 Vasculitis
 Connective tissue di...
Clinical features
 Pulsatile mass
 Painful ,tender mass , fever
 Neurological symptoms
 Cranial nerve dysfunction
 Dy...
Differential diagnosis
 Tortuous , kinked /coiled carotid
artery
 Prominent carotid bifurcation
 Cervical lymphnodes ov...
Investigation
 Duplex ultrasound – limitation ?
 CTA ; Advantages
;bony anatomical landmark
;circle of willis
; brain im...
Treatment
 Surgical Reconstruction
 Endovascular
Advantage
 Avoiding difficult dissection
 Proximal control is difficult
 Reduce the risk of cranial nerve
injuries
 CO...
Post procedure
 Surgical reconstruction ; Aspirin
 Endovascular treatment ; clopidogrel
: Aspirin
* Statins
 Form 2010 – 2013 we have total
29 cases
 Out of them 18 have surgical
reconstruction
 11 have endovascular procedure
European journal of vascular &
endovascular surgery
 From Jan 1998 to Dec 2011 ,50
consecutive interventions for ICA
aneu...
Reference
Otolaryngology head & neck surgery ;
Charles W. Cummings
Surgery of the chest ; Sabiston &
Spencer
Thank you
Ica  aneurysm
Ica  aneurysm
Ica  aneurysm
Ica  aneurysm
Ica  aneurysm
Upcoming SlideShare
Loading in...5
×

Ica aneurysm

195

Published on

Published in: Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
195
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
2
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Ica aneurysm

  1. 1. Case study
  2. 2. Case  16 years male presented with complaints of dizziness associated with transient loss of vision ? in the right eye over the past one month
  3. 3. Diagnosis ?
  4. 4. History ?
  5. 5.  Any neurological deficit  Trauma  Any surgery  Fever, joint pain ?
  6. 6. Examination ?
  7. 7.  Swelling  Pulsatile mass  Oral cavity  Carotid bruit  Horner’s syndrome
  8. 8. Complication ?
  9. 9.  Thromboembolism  Neurological complications  Rupture
  10. 10. Management ?
  11. 11.  Surgical reconstruction  Endovascular treatment
  12. 12. Complication ?
  13. 13.  Thrombosis  Endoleak  Perforation  Migration  Infection  Dissection of artery
  14. 14. Carotid Artery Aneurysm
  15. 15. Introduction  Aneurysm of extracranial carotid artery (ECAA) is an uncommon but important clinical entity  Incidence of intracranial carotid artery aneurysm (0.8 – 18 %) and ECAA is 1- 1.5 %  ECAA is less than 1 % of all carotid pathologies
  16. 16. Definition  The accepted difinition of most arterial aneurysm is 50 % increase in diameter compared to the normal diameter of artery.  But in case of carotid bifurcation diameter should be 200 % more than ICA / 150 % of CCA
  17. 17. Etiology  Degenerative / Atherosclerosis  Post traumatic causes  Postendarterectomy  Vasculitis  Connective tissue disorder  Mycotic Aneurysm /SABE
  18. 18. Clinical features  Pulsatile mass  Painful ,tender mass , fever  Neurological symptoms  Cranial nerve dysfunction  Dysphagia  Hemorrhage and rupture
  19. 19. Differential diagnosis  Tortuous , kinked /coiled carotid artery  Prominent carotid bifurcation  Cervical lymphnodes overlying the carotid bifurcation  CBT  Cervical metastatic disease  Branchial cyst  Cystic hygroma
  20. 20. Investigation  Duplex ultrasound – limitation ?  CTA ; Advantages ;bony anatomical landmark ;circle of willis ; brain imaging
  21. 21. Treatment  Surgical Reconstruction  Endovascular
  22. 22. Advantage  Avoiding difficult dissection  Proximal control is difficult  Reduce the risk of cranial nerve injuries  CONTRAINDICATION  Unstable Thrombs  Very tortuous carotid arteries
  23. 23. Post procedure  Surgical reconstruction ; Aspirin  Endovascular treatment ; clopidogrel : Aspirin * Statins
  24. 24.  Form 2010 – 2013 we have total 29 cases  Out of them 18 have surgical reconstruction  11 have endovascular procedure
  25. 25. European journal of vascular & endovascular surgery  From Jan 1998 to Dec 2011 ,50 consecutive interventions for ICA aneurysmal disease was performed  3 patients developed major stroke  6 patients had cranial nerve injuries  3 patients had Thrombosis  Conclusion; surgical treatment provided satisfactory early & long term result,selected patients with non infected aneurysm endovascular option seems to be feasile
  26. 26. Reference Otolaryngology head & neck surgery ; Charles W. Cummings Surgery of the chest ; Sabiston & Spencer
  27. 27. Thank you
  1. A particular slide catching your eye?

    Clipping is a handy way to collect important slides you want to go back to later.

×