Extracranial carotid and vertebral artery aneurysms

Chronic fusiform extracranial vertebral artery aneurysm with recurrent posterior circulation emboli: Case report and review of the literature

We report a case of a 64-year-old man with a fusiform right extracranial vertebral artery aneurysm, spanning over half the extra-cranial V2 (foraminal) segment, presenting with recurrent multi-focal posterior circulation embolic ischaemic stroke. The patient was treated with endovascular embolisation of the right vertebral artery to prevent further thrombo-embolic events. Distal and proximal occlusion of the aneurysmal vertebral artery was performed with a micro-vascular plug with partial aneurysm sack embolisation to aid thrombosis and reduce the risk of recanalisation. Two months post procedure MR angiography confirmed successful aneurysm occlusion with no post-procedural complication. The patient returned to his normal independent life. Endovascular treatment with vessel sacrifice is an effective treatment with low morbidity and we believe the MVP device to be a efficacious option in the vertebral artery.

Aneurysm of the common carotid artery as a sequel of puncture angiography

The case of a 60-year-old man with a large aneurysm of the common carotid artery, which manifested five months after puncture angiography, is described. This was successfully managed by aneurysm exclusion and aortocarotid bypass. The etiology of the aneurysm is discussed.

Spontaneous aneurysm of the extracranial vertebral artery associated with spinal osseous anomaly

Spontaneous aneurysms of the extracranial vertebral artery are uncommon. We report the case of an aneurysm located at the second cervical vertebra, associated with a congenital spinal malformation. Computed tomographic scan and arteriography were diagnostic. After proximal ligation of the vertebral artery, the aneurysm was incised and the distal vertebral artery was revascularized by an infraoccipital carotid-to-vertebral artery vein bypass.

Mycotic cervical carotid artery aneurysms: a case report and review of the literature

Mycotic cervical carotid artery aneurysms are rare. We report one case successfully treated by resection and reconstruction with a saphenous vein interposition graft. A review of the English world literature revealed 22 additional cases. Principles of management include appropriate and timely antibiotic use, resection of the aneurysm, debridement of all infected tissue, and restoration of arterial continuity with autogenous tissue through uninvolved tissue planes.

The bull's-eye sign of extracranial cervical aneurysms

Extracranial, cervical aneurysms and arterial thrombosis are uncommon entities. In most cases, they have diagnostic clinical presentations. However, on occasion the history and physical findings do not clearly suggest their presence. In these cases, postcontrast computed tomography scans can aid in rapidly establishing the correct diagnosis by revealing a "bull's-eye" appearance within the mass (vessel lumen). The diagnosis is less difficult to make when the involved vessel is the carotid artery, because this artery is routinely identified on postcontrast computed tomography scans and the lesion can be easily placed along its course. The vascular origin of such a lesion is not usually evident on computed tomography if the process does not lie along the course of a major vessel. In these cases, the bull's-eye sign can establish the diagnosis so that prompt consideration can be given to angiography and therapy.

Hemodynamic analysis of associated extracranial atraumatic vertebral artery aneurysm and arteriovenous fistula. Case report

A case of atraumatic arteriovenous (AV) fistula of the extracranial vertebral artery associated with an atraumatic aneurysm of the contralateral extracranial vertebral artery is reported. The fistulous lesion was excised after distal and proximal ligation of the vessel. Subsequently, the contralateral aneurysm underwent spontaneous dissolution. Seven cases of extracranial vertebral AV fistulae associated with ipsilateral vertebral artery aneurysms (four traumatic and three as part of vascular dysplastic syndromes) have been reported previously.