Carotid artery pseudoaneurysm after carotid endarterectomy: case report

Year 2019, , 207 - 210, 01.06.2019

Hatice Kaplanoğlu , Osman Beton

https://doi.org/10.21601/ortadogutipdergisi.358029

Abstract

Extracranial carotid artery aneurysms
are quite rare. They account for 0.4% to 4% of all peripheral arterial aneurysms.
Precise treatment is essential in order to avoid neurological complications of aneurysms.
A 67-year-old male patient was admitted to the cardiology outpatient clinic of our
hospital three months ago, with complaints of chest pain during exertion. The effort
test of the case revealed a positive result, and coronary angiography revealed stenosis in the coronary arteries.
The carotis doppler ultrasonography revealed plaque in the left internal carotid
artery, causing 80% narrowing in the lumen. Four vessels were determine to be bypassed,
and a left carotid endarterectomy was applied in the same session. Swelling and
cyanosis were present in the patient’s neck two days after the operation. The control
doppler ultrasonography revealed the development of an aneurysm in the left internal
carotid artery. The patient was operated on again one week after the first operation,
and end-to-end anastomosis was applied with a saphenous vein interposition graft.
The decision was made for follow-ups with doppler ultrasonography controls in six-month
intervals.

Keywords

Carotid arteries, carotid aneurysm, surgery, endovascular techniques

Karotid endarterektomi sonrası karotid arter psödoanevrizması: olgu sunumu

Abstract

Ekstrakranial karotid arter anevrizmaları oldukça nadirdir. Tüm periferal arter
anevrizmalarının %0.4-4’ünü oluşturmaktadır. Anevrizmaların nörolojik komplikasyonlarından
kaçınmak için kesin tedavi gerekmektedir. Altmış yedi yaşında erkek hasta, üç ay
önce efor sırasında ortaya çıkan göğüs ağrısı şikayeti ile hastanemiz kardiyoloji
polikliniğine başvuruyor. Olguya yapılan efor testinin pozitif çıktı ve koroner
anjiyografide koroner arterlerde darlık saptandı. Karotis Doppler ultrasonografide,
sol internal karotid arterde %80 darlığa neden olan plak vardı. Dört damar bypass
kararı alındı ve aynı senasta sol karotid endarterektomi yapıldı. Operasyonu takiben
iki gün sonra hastanın boynunda şişlik ve morarma görüldü. Yapılan kontrol Doppler
ultrasonografide sol internal karotid arterde anevrizma geliştiği izlendi. İlk operasyonu
takiben bir hafta sonra tekrar opere edildi ve safen ven greft interpozisyonu ile
uç uca anastamoz yapıldı. Altı aylık Doppler ultrasonografi kontrolleri ile takibi
alındı.

Keywords

Karotid arterler, karotis anevrizması, cerrahi, endovasküler teknikler

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