Surgical treatment of extracranial internal carotid artery aneurysms

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Presentation transcript:

Surgical treatment of extracranial internal carotid artery aneurysms Eugenio Rosset, MD, Jean-Noel Albertini, MD, Pierre Edouard Magnan, MD, Bertrand Ede, MD, Jean Marc Thomassin, MD, Alain Branchereau, MD Journal of Vascular Surgery Volume 31, Issue 4, Pages 713-723 (April 2000) DOI: 10.1067/mva.2000.104102 Copyright © 2000 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 The division of the ICA in three segments: segment 1, the bicarotid region; segment 2, the retrostyloid region. The dashed oblique line (corresponding to the Blaisdell line between the tip of the mastoid process and the angle of the jaw) separates segment 1 from segment 2; and segment 3, the infratemporal fossa before penetration into the base of the skull. Journal of Vascular Surgery 2000 31, 713-723DOI: (10.1067/mva.2000.104102) Copyright © 2000 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 A, An exposure of the distal ICA after drilling the vaginal process of the tympanal bone and the tip of the mastoid process. A special retractor maintains mandibular subluxation. B, An inferior view of the base of the skull, showing the extended bone resection and exposure of the carotid artery. 1 , Facial nerve; 2 , area of mastoid process drilling; 3 , area of vaginal process drilling; 4 , glenoid cavity; 5 , jugular foramen. Journal of Vascular Surgery 2000 31, 713-723DOI: (10.1067/mva.2000.104102) Copyright © 2000 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Angiogram of a dysplastic aneurysm located at segment 2. Arrows show irregularities, suggesting parietal clot and dysplastic lesions. Journal of Vascular Surgery 2000 31, 713-723DOI: (10.1067/mva.2000.104102) Copyright © 2000 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 A, An angiogram of a traumatic aneurysm located at the base of the skull in a 24-year-old man. B, CT scan with three-dimensional reconstruction. The lateral reconstruction shows the aneurysm (arrows ), where the artery penetrates into the carotid canal. C, Follow-up angiogram after reconstruction. Venous graft was performed through an infratemporal approach. Journal of Vascular Surgery 2000 31, 713-723DOI: (10.1067/mva.2000.104102) Copyright © 2000 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions