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Srpski arhiv za celokupno lekarstvo 2017 Volume 145, Issue 11-12, Pages: 643-645
https://doi.org/10.2298/SARH151228120M
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Surgical treatment of a carotid artery aneurysm associated with kinking: A case report and review of literature

Matić Predrag (Vascular Surgery Clinic, “Dedinje” Cardiovascular Institute, Belgrade + School of Medicine, Belgrade)
Nešković Mihailo (Vascular Surgery Clinic, “Dedinje” Cardiovascular Institute, Belgrade)
Nenezić Dragoslav (Vascular Surgery Clinic, “Dedinje” Cardiovascular Institute, Belgrade + School of Medicine, Belgrade)
Tanasković Slobodan ORCID iD icon (Vascular Surgery Clinic, “Dedinje” Cardiovascular Institute, Belgrade + School of Medicine, Belgrade)
Babić Srđan (Vascular Surgery Clinic, “Dedinje” Cardiovascular Institute, Belgrade + School of Medicine, Belgrade)
Popov Petar (Vascular Surgery Clinic, “Dedinje” Cardiovascular Institute, Belgrade + School of Medicine, Belgrade)
Radak Đorđe (Vascular Surgery Clinic, “Dedinje” Cardiovascular Institute, Belgrade + School of Medicine, Belgrade)

Introduction. An extracranial carotid artery aneurysm is a rare clinical entity with potentially debilitating consequences. Our aim is to present a case of a large internal carotid artery aneurysm combined with medial internal carotid artery (ICA) kinking successfully treated by resection with an end-to-end anastomosis. Case outline. A 34-year-old female patient was admitted to our hospital due to dizziness and frequent non-specific headaches. On admission, routine echocardiography showed an aneurysm of the atrial septum. Multislice computed tomography of the supraaortic branches showed medial kinking of the right ICA with a 15 mm aneurysm localized on the vertex of the angulation. Kinking was present on the left ICA as well, with a small aneurysm of 5 mm in diameter. The right ICA aneurysm was resected and the artery was reconstructed with an end-to-end anastomosis. The postoperative course was uneventful and the patient was symptom-free after a one-year follow-up. Conclusion. We showed that surgery of an aneurysm and kinking of the carotid artery in the medial segment of the ICA is possible and safe to perform. Detailed preoperative preparation, precise surgical technique, and short clamping time all contributed to a good final outcome.

Keywords: carotid artery aneurysm, kinking, surgical treatment