What Is a Carotid Aneurysm?

Carotid aneurysms refer to aneurysms of the common carotid artery, the extracranial segment of the internal carotid artery, and the external carotid artery and its branches. They occur in the carotid bifurcation, and a few occur in the internal carotid artery and the common carotid artery. Such aneurysms are rare, accounting for about 2% of peripheral aneurysms, and most are unilateral lesions. Often caused by atherosclerosis, trauma and infection, congenital and middle cystic changes are rare, and very few are iatrogenic. The main symptoms are palpable swelling and pulsatile mass in the neck of the affected side, which may have compression symptoms, such as hoarseness, choking on eating, and difficulty breathing. Sometimes systolic murmurs can be heard at the mass.

Basic Information

Visiting department: General Surgery
Common causes: It can be caused by arteriosclerosis, infection, trauma, congenital and middle cystic degeneration.

Common symptoms: An expansive pulsatile mass appears on one side of the neck, which may be accompanied by local pain.
Contagious: no

Causes of carotid aneurysms

Carotid aneurysms are similar to other aneurysms and can be caused by arteriosclerosis, infection, trauma, congenital and middle cystic degeneration, but arteriosclerosis is the most common cause and can also be caused by surgery, especially by intra-arterial After membrane peeling, anastomotic pseudoaneurysms due to weak blood vessel walls or vascular graft transplantation are also more common causes.

Carotid aneurysm clinical manifestations

1. The most common clinical manifestation is an expansive pulsatile mass on one side of the neck, which may be accompanied by local pain. The mass is often audible and systolic murmurs are heard, but when there is a large mural thrombus, the murmurs are often not heard.
2. When carotid aneurysms affect the intracranial blood supply, different degrees of cerebral ischemia can occur.
3 After carotid aneurysm enlargement, swallowing difficulties, tracheal displacement, and difficulty breathing due to mass compression may occur. Hoarseness can occur when the recurrent laryngeal nerve is compressed, and Horner syndrome can occur when the sympathetic nerve is compressed.
4 When the tumor ruptures and bleeds, it can cause throat, nose or ear bleeding or even suffocation.

Carotid aneurysm examination

(1) Ultrasound: It can clearly show the location, size and internal blood flow of the tumor, and at the same time understand the relationship between the tumor and blood vessels. It is the first choice for clinical imaging examination.
(2) MRA examination: can show the structure without being covered by liquid or bone, and can find aneurysms with a diameter of more than millimeters.
(3) Carotid angiography: Cerebral angiography is the gold standard for diagnosing aneurysms. Not only can it clearly show the location, size, and shape of the aneurysm, it can also accurately measure the width of the aneurysm, determine the type of aneurysm, and the aneurysm and its load The spatial anatomical relationship between the aneurysm and the important branch of the aneurysm provides a basis for further treatment options.

Carotid aneurysm diagnosis

1. Vascular ultrasound, CT, and MRI are of great value in clear diagnosis, and can clearly show the anatomical location of the carotid arteries, as well as the size and shape of the aneurysm, the presence or absence of thrombus, proximity, and the effect on intracranial blood supply.
2. Carotid angiography (DSA) is the gold standard for diagnosing and formulating surgical schemes. It has a decisive role in the formulation of surgical schemes. It can determine the nature and scope of tumors, and the patency of inflow and outflow tracts. Case of internal artery and Willis ring.

Carotid aneurysm treatment

1. Carotid aneurysms should be treated as soon as they are diagnosed, because the tumors continue to grow, compressing adjacent tissues and organs, and they are at risk of rupture and cerebral embolism at any time. If the condition allows matas test (carotid compression test) as much as possible before surgery. That is, the common carotid artery of the affected side is blocked by shiatsu, and its blood flow is blocked 2 to 4 times per day to improve the circulation of the collateral circulation of the skull base movement ring, gradually to block no signs of cerebral ischemia for more than 3 to 25 minutes each time, Only consider surgery.
2. The smaller cystic aneurysm is free and the tumor is excised and the incision is sutured.
3 Dissecting aneurysms resected diseased arteries and reconstructed blood flow channels with artificial blood vessels.
4 Interventional therapy can be used for elderly patients with severe cardiovascular disease who cannot tolerate surgery.