Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Carotid and vertebral artery aneurysms: diagnostic and treatment methods

Authors: Bockeria L.A., Abdulgasanov R.A., Shogenov M.A.

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

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DOI: https://doi.org/10.24022/1814-6910-2024-21-4-323-331

UDC: 616.133+616.134.9]-007.64

Link: Clinical Physiology of Blood Circulaiton. 2024; 21 (4): 323-331

Quote as: Bockeria L.A., Abdulgasanov R.A., Shogenov M.A. Carotid and vertebral artery aneurysms: diagnostic and treatment methods. Clinical Physiology of Circulation. 2024; 21 (4): 323–331 (in Russ.). DOI: 10.24022/1814-6910-2024-21-4-323-331

Received / Accepted:  09.10.2024 / 28.11.2024

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Abstract

Carotid artery and vertebral artery aneurysms are uncommon. The symptoms of these aneurysms vary according to their location and size. Larger aneurysms may present as cervical or parapharyngeal masses, which may or may not be pulsatile or tender; there may be an associated systolic bruit. Pharyngeal hemorrhage, epistaxis, or bleeding from the ear are rare manifestations. Ischemic symptoms are a frequent mode of presentation of these aneurysms. Arterial diseases, particularly atherosclerosis, may predispose the vessel to the formation of the aneurysm. Sometimes trauma is the cause. Carotid artery aneurysms can be treated by carotid ligation or surgical reconstruction. Five distinct clinical types of aneurysms are reported with different symptoms and treatment. Fusiform, saccular, false, and mycotic aneurysms are best treated with interposition autogenous vein grafting. Spontaneous dissection aneurysms are best treated initially with anticoagulation and follow-up angiography. Recanalization is the usual result. Meticulous surgical technique to prevent perioperative emboli is essential to prevent central nervous system complications. Vertebral artery aneurysms are even rarer. And the main method of treatment is endovascular, due to the small diameter and complex surgical access.

About Authors

  • Leo A. Bockeria, Dr. Med. Sci., Professor, Academician of Russian Academy of Sciences, President; ORCID
  • Ramiz A. Abdulgasanov, Dr. Med. Sci., Chief Researcher; ORCID
  • Mukhamed A. Shogenov, Cardiovascular Surgeon; ORCID

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