Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + • Rare• May occur anywhere along extracranial portion +++ Epidemiology +++ True Aneurysms + • Caused by-Atherosclerosis-Occasionally by cystic medial necrosis, Marfan syndrome, or fibromuscular dysplasia +++ False Aneurysms + • Occur rarely after carotid endarterectomy• Occur as result of trauma, or infection (pharyngeal abscess) +++ Symptoms and Signs + • Pulsatile neck mass• Dysphagia can occur from protrusion into oropharynx• Neck pain, radiating to jaw• 30% present with transient ischemic attacks• Rupture (more common with false aneurysms) into oropharynx, ear canal, soft tissues of neck +++ Imaging Findings + • Duplex US: Initial test• Arteriography necessary to plan surgery + • Duplex US will differentiate redundant carotid artery from aneurismal and identify occlusive disease +++ Rule Out + • Coiled or redundant carotid artery, subclavian artery (can present as pulsatile neck mass) + • Duplex US• Angiography prior to surgery• Consider CT if infection or traumatic + • If accessible, resect and replace aneurysm with graft or vein• Endovascular stenting may be an option• False aneurysms should be repaired• Can ligate extensive aneurysm if back pressure > 65 mm Hg-Can identify potential candidates with awake arteriography and balloon occlusion +++ Surgery +++ Indications + • True or false aneurysm +++ Prognosis + • Good if repairable +++ Preferences + • El-Sabrout R et al. Extracranial carotid artery aneurysms: Texas Heart Institute experience. J Vasc Surg. 2000;31:702.• Rosset E et al. Surgical treatment of extracranial internal carotid artery aneurysms. J Vasc Surg. 2000;31:713. Your Access profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth