The Surgical Management and Histology of Symptomatic large Extra Cranial Internal Carotid Artery Aneurysms

The aim of the present study is to describe the treatment strategy and histological findings in patients with large extracranial internal carotid artery (ICA) aneurysms. The resection of the aneurysm and end-to-end anastomosis of the ICA was performed in Case 1 because the patient displayed balloon test occlusion (BTO) intolerance and ICA coiling. Case 2 was treated with an extracranial to intracranial bypass and proximal ICA ligation without BTO. Endovascular embolization of the proximal ICA was performed in Case 3 because the patient displayed tolerance to BTO. The etiology of the aneurysm in Case 2 was determined to be vascular Behçet disease. The findings of these cases indicate that extracranial ICA aneurysms should be treated according to the anatomical, radiological and etiological factors of the aneurysms.