Extracranial Internal Carotid Artery Aneurysms: case report of a saccular wide-necked aneurysm and review of the literature.

PURPOSE To describe a case of atherosclerotic Extracranial internal Carotid Artery Aneurysm (ECAA) with an unique "diverticulum-like" morphological structure, surgically treated and to review the experiences of major referral centers. CASE REPORT A 76-year-old woman presented with persistent dysphagia and transient hypophonia caused by a growing pulsatiling mass of the neck; duplex ultrasonography and angio-CT scan demonstrated a wide-necked, saccular aneurysm at the origin of the right Internal Carotid Artery (ICA). A total aneurysmectomy with patch angioplasty of the aneurysm of the neck on the carotid wall was successfully performed. No perioperative complications were encountered; at one year follow-up the patient was asymptomatic without any neurological complication and with carotid patency. CONCLUSIONS Open surgery remains the gold standard for the treatment of extracranial internal carotid artery aneurysms in terms of patency and reduced risk of adverse complications; endovascular procedures may, in selected cases, provide a valuable additional tool in the armoury of the physician.