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Stent Graft Treatment of a Right Carotid Artery Aneurysm
Joseph D. Vijungco, M.D. and Melina R. Kibbe, M.D.
Feinberg School of Medicine, Northwestern University
 


A 51-year-old male presented with a history of an asymptomatic right carotid artery aneurysm found on a routine computed tomography (CT) scan performed for follow-up of a treated head and neck cancer. The patient had a past medical history significant for a right-sided squamous cell tongue carcinoma that was treated with local resection and reconstruction using an iliac crest bone approximately 10 years prior. Several years later, the patient received neck irradiation followed by a right modified radical neck dissection.

The CT scan revealed that the aneurysm was located proximal to the carotid bifurcation and extended into the internal carotid artery (Figure 1). Thrombus was present within the carotid artery aneurysm.

Figure 1. Computed tomography scan of the neck reveals the carotid aneurysm with extension into the right internal carotid artery (arrow).

The patient was taken to the operating room and underwent exclusion of the carotid aneurysm using covered stent grafts. Two stent graft devices (7 x 30 mm and 8 x 20 mm Viabahn Endoprostheses, W.L Gore and Associates, Flagstaff, AZ) were used to ensure complete coverage of the external carotid artery, thereby avoiding an endoleak. The proximal landing zone of the stent graft was in the common carotid artery and the distal landing zone was in the internal carotid artery (Figure 2).

Post-operatively, the patient did well and was discharged with no complications.

Figure 2. Completion carotid angiogram shows the treated aneurysm. Note coverage of the external carotid artery by two covered stent grafts placed in the common carotid artery and extending into the internal carotid artery.
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