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 The following is a summary of “Management of large or giant Extracranial carotid artery aneurysms: a single-center experience,” published in the November 2024 issue of Neurology by AXiEr et al.  

Extracranial carotid artery aneurysms (ECAA) are rare, occurring in less than 1% of cases. The best method of treatment for ECAA still needs to be well-defined.  

Researchers conducted a retrospective study to share their experience with treatment options for large ECAAs.  

They reviewed 15 treated patients (19 ECAAs) (2015 to 2022). Data on treatment methods, patient demographics, aneurysm characteristics, and clinical and radiographic follow-up were collected.  

The results showed 15 patients (8 male, 53.3%) with 19 ECAAs. The average age was 53.6 years, with 66.7% presenting pulsatile neck mass. The causes of ECAAs included atherosclerosis (40.0%), infection (20.0%), dissection (6.7%), and iatrogenic causes due to acupuncture (6.7%). The average aneurysm diameter was 23.8 ± 14.1 mm, with more than half having aneurysms larger than 25 mm. Of the cases, 79.0% had an intraluminal thrombus at admission, 6 patients underwent neurosurgical resection for seven ECAAs, 5 received endovascular treatment, and 4 were observed. After a mean follow-up of 28.1 months, 10 of the treated aneurysms showed complete occlusion, 1 aneurysm resolved with anti-infection treatment, and 1 patient who received a Willis stent experienced a cerebral infarction and died.  

They concluded that neurosurgical treatment was more common for large ECAAs, endovascular surgery was preferred for pseudoaneurysms and dissecting aneurysms, and anti-inflammatory treatment was effective for some infectious cases.  

Source: bmcneurol.biomedcentral.com/articles/10.1186/s12883-024-03970-z