Ekstrakranial İnternal Karotis Arter Anevrizmasında Cerrahi Tedavi: Bir Olgu Sunumu
Atmış dört yaşında bayan hasta, sol servikal bölgede bir yıldır var olan pulsatil kitle nedeniyle hastaneye başvurdu. Şikayetleri son bir aydır artan hastanın, servikal travma ya da enfeksiyon öyküsü yoktu. Mandibulanın sol servikal bölgesinde 3x4 cm' lik vasküler üfürüm alınan bir kitle gözlendi. Tomografik anjiografide, sol internal karotis arterde 32x30x25 mm' lik sakküler bir anevrizma olduğu görüldü. Anevrizma rezeke edilerek çıkartıldı ve internal karotis arterin proksimal ve distali uç uca anastomoz edildi. Postoperatif erken takiplerinde tam bir iyileşme gözlendi. Patolojik incelemede arter duvarında, fibropilazi, mukus dejenerasyonu, hiyalinizasyon, kronik inflamatuar hücre infiltrasyonu ve yerel kalsifikasyon gözlendi. İyileşme komplikasyon olmadan gerçekleşti. Anahtar kelimeler: İnternal Karotid Arter; Anevrizma; Anastomoz; Cerrahi.
Surgical Treatment of Extracranial Internal Carotid Artery Aneurysm: A Case Report
A sixty four year-old female patient was admitted to the hospital with complaints of pulsatile mass in her left cervical area for one year, which had abruptly augmented one month earlier. No cervical trauma or infection appeared to be present. There was a 3x4cm pulsatile mass in the left cervical angle of the mandible, which could be observed with vascular murmur. Tomographic angiography showed a saccular aneurysm of 32x30x25mm in diameter in the left ICA. Aneurysmal dilatation was resected and primarily repaired by end-to-end anastomosis. The postoperative recovery was uneventful. Histopathologic examination showed hyperplasia in artery wall, mucous degeneration, hyalinization, chronic inflammatory cell infiltration, and local calcification. The patient was doing well during the early follow-up period without complications. Key words: Internal Carotid Artery; Aneurysm; Anastomosis; Surgical.A sixty four year-old female patient was admitted to the hospital
___
- Mansour A. Recurrent carotid stenosis: prevention, surveillance, and management. Semin Vasc Surg. 1998;11:30–5.
- Pulli R, Gatti M, Credi G, Narcetti S, Capaccioli L, Pratesi C, Extracranial carotid artery aneurysms. J Cardiovasc Surg. 1997;38:339–46.
- Mokri B, Piepgras DG, Sundt TM, Pearson BW. Extracranial internal carotid artery aneurysms. Mayo Clin Proc. 1982;57:310–21.
- Winslow N. Extracranial aneurysm of the internal carotid artery: history and analysis of the cases registered up to 8/1/1925. Arch Surg. 1926;13;689–729.
- Archie JP. Patching with carotid endarterectomy: when to do it and what to use. Semin Vasc Surg. 1998;11:24–9.
- Alimi YS, Di Mauro P, Fiacre E, Magnan J, Juhan C. Blunt injury to the internal carotid artery at the base of the skull: six cases of venus graft restoration. J Vasc Surg. 1996;24:249-57.
- Schievink WI, Piegras DG, McCaffrey TV, Mokri B. Surgical treatment of extracranial internal carotid artery dissecting aneurysms. Neurosurgery. 1994;35:809–15.
- Radak D, Davidovic L, Tanaskovic S, Banzic I, Matic P, Babic S, Kostic D, Isenovic ER. A tailored approach to operative repair of extracranial carotid aneurysms based on anatomic types and kinks. Am J Surg. 2014;208:235-42.