180-degre carotid bifurcation with an internal carotid artery aneurysm. 2023

Grigol Keshelava, and David Kovziridze, and Zurab Robakidze
Department of Vascular Surgery, Clinic "Helsicore", Tevdore Mgvdeli St. 13, 0121, Tbilisi, Georgia. gagakeshelava@gmail.com.

OBJECTIVE Internal carotid artery (ICA) aneurysm is a rare pathology. In the clinical case we present, the patient had an ICA aneurysm as well as a rare anatomical variant of the carotid bifurcation. METHODS We present the case of a 45 year old man, who had two episodes of TIA revealed by loss of mind. Computed tomography revealed the fusiform aneurysm of a left ICA in the first segment with maximal diameter of 16 mm. There were no thrombotic mass in the dilated area. The carotid bifurcation angle was 180 degree. Although the aneurysm did not contain a thrombus mass, it was considered the source of the TIA because of turbulent blood flow. RESULTS Distal and proximal ligation was performed. A 5-cm long graft from the great saphenous vein was used for ICA revascularization from common carotid artery. CONCLUSIONS In our case, geometry of carotid bifurcation may have contributed to the ICA aneurysm, although there is no evidence for this correlation.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002340 Carotid Artery Diseases Pathological conditions involving the CAROTID ARTERIES, including the common, internal, and external carotid arteries. ATHEROSCLEROSIS and TRAUMA are relatively frequent causes of carotid artery pathology. Carotid Atherosclerosis,Common Carotid Artery Disease,Internal Carotid Artery Disease,Arterial Diseases, Carotid,Arterial Diseases, Common Carotid,Arterial Diseases, External Carotid,Arterial Diseases, Internal Carotid,Atherosclerotic Disease, Carotid,Carotid Artery Disorders,Carotid Atherosclerotic Disease,Common Carotid Artery Diseases,External Carotid Artery Diseases,Internal Carotid Artery Diseases,Arterial Disease, Carotid,Artery Disease, Carotid,Artery Diseases, Carotid,Artery Disorder, Carotid,Artery Disorders, Carotid,Atherosclerotic Diseases, Carotid,Carotid Arterial Disease,Carotid Arterial Diseases,Carotid Artery Disease,Carotid Artery Disorder,Carotid Atheroscleroses,Carotid Atherosclerotic Diseases,Disorders, Carotid Artery
D002343 Carotid Artery, Internal Branch of the common carotid artery which supplies the anterior part of the brain, the eye and its appendages, the forehead and nose. Arteries, Internal Carotid,Artery, Internal Carotid,Carotid Arteries, Internal,Internal Carotid Arteries,Internal Carotid Artery
D002532 Intracranial Aneurysm Abnormal outpouching in the wall of intracranial blood vessels. Most common are the saccular (berry) aneurysms located at branch points in CIRCLE OF WILLIS at the base of the brain. Vessel rupture results in SUBARACHNOID HEMORRHAGE or INTRACRANIAL HEMORRHAGES. Giant aneurysms (>2.5 cm in diameter) may compress adjacent structures, including the OCULOMOTOR NERVE. (From Adams et al., Principles of Neurology, 6th ed, p841) Aneurysm, Cerebral,Aneurysm, Intracranial,Basilar Artery Aneurysm,Berry Aneurysm,Brain Aneurysm,Cerebral Aneurysm,Giant Intracranial Aneurysm,Mycotic Aneurysm, Intracranial,Aneurysm, Anterior Cerebral Artery,Aneurysm, Anterior Communicating Artery,Aneurysm, Basilar Artery,Aneurysm, Middle Cerebral Artery,Aneurysm, Posterior Cerebral Artery,Aneurysm, Posterior Communicating Artery,Anterior Cerebral Artery Aneurysm,Anterior Communicating Artery Aneurysm,Middle Cerebral Artery Aneurysm,Posterior Cerebral Artery Aneurysm,Posterior Communicating Artery Aneurysm,Aneurysm, Berry,Aneurysm, Brain,Aneurysm, Giant Intracranial,Aneurysm, Intracranial Mycotic,Aneurysms, Basilar Artery,Aneurysms, Berry,Aneurysms, Brain,Aneurysms, Cerebral,Aneurysms, Giant Intracranial,Aneurysms, Intracranial,Aneurysms, Intracranial Mycotic,Artery Aneurysm, Basilar,Artery Aneurysms, Basilar,Basilar Artery Aneurysms,Berry Aneurysms,Brain Aneurysms,Cerebral Aneurysms,Giant Intracranial Aneurysms,Intracranial Aneurysm, Giant,Intracranial Aneurysms,Intracranial Aneurysms, Giant,Intracranial Mycotic Aneurysm,Intracranial Mycotic Aneurysms,Mycotic Aneurysms, Intracranial
D002548 Cerebral Revascularization Microsurgical revascularization to improve intracranial circulation. It usually involves joining the extracranial circulation to the intracranial circulation but may include extracranial revascularization (e.g., subclavian-vertebral artery bypass, subclavian-external carotid artery bypass). It is performed by joining two arteries (direct anastomosis or use of graft) or by free autologous transplantation of highly vascularized tissue to the surface of the brain. Brain Revascularization,EC-IC Arterial Bypass,Extracranial-Intracranial Arterial Bypass,Microsurgical Revascularization, Cerebral,STA-MCA Bypass,Cerebral Microsurgical Revascularization,Arterial Bypass, EC-IC,Arterial Bypass, Extracranial-Intracranial,Arterial Bypasses, EC-IC,Arterial Bypasses, Extracranial-Intracranial,Bypass, EC-IC Arterial,Bypass, Extracranial-Intracranial Arterial,Bypass, STA-MCA,Bypasses, EC-IC Arterial,Bypasses, Extracranial-Intracranial Arterial,Bypasses, STA-MCA,Cerebral Microsurgical Revascularizations,EC IC Arterial Bypass,EC-IC Arterial Bypasses,Extracranial Intracranial Arterial Bypass,Extracranial-Intracranial Arterial Bypasses,Revascularization, Brain,Revascularization, Cerebral,Revascularization, Cerebral Microsurgical,STA MCA Bypass,STA-MCA Bypasses
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D017536 Carotid Artery, Common The two principal arteries supplying the structures of the head and neck. They ascend in the neck, one on each side, and at the level of the upper border of the thyroid cartilage, each divides into two branches, the external (CAROTID ARTERY, EXTERNAL) and internal (CAROTID ARTERY, INTERNAL) carotid arteries. Common Carotid Artery,Arteries, Common Carotid,Artery, Common Carotid,Carotid Arteries, Common,Common Carotid Arteries

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