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CC BY-NC-ND 4.0 · Asian J Neurosurg 2017; 12(03): 382-388
DOI: 10.4103/1793-5482.180930
REVIEW ARTICLE

Surgical treatment of large and giant cavernous carotid aneurysms

Kitiporn Sriamornrattanakul
Department of Surgery, Division of Neurosurgery, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok
,
Ittichai Sakarunchai
1   Department of Surgery, Division of Neurosurgery, Prince of Songkla University, Songkhla
,
Kei Yamashiro
2   Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya
,
Yasuhiro Yamada
2   Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya
,
Daisuke Suyama
2   Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya
,
Tsukasa Kawase
2   Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya
,
Yoko Kato
2   Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya
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Cavernous carotid aneurysms (CCAs) are uncommon pathologic entities. Extradural place and the skull base location make this type of an aneurysm different in clinical features and treatment techniques. Direct aneurysm clipping is technically difficult and results in a significant postoperative neurological deficit. Therefore, several techniques of indirect surgical treatment were developed with different surgical outcomes, such as proximal occlusion of internal carotid artery (ICA) or trapping with or without bypass (superficial temporal artery-middle cerebral artery bypass or high-flow bypass). High-flow bypass with proximal ICA occlusion seems to be the most appropriate surgical treatment for CCA because of the high rate of symptom improvement, aneurysm thrombosis, and minimal postoperative complications. However, in cases of CCA presented with direct carotid-cavernous fistula, the appropriate surgical treatment is high-flow bypass with aneurysm trapping, which the fistula can be obliterated immediately after surgery.

Key-words:

Cavernous carotid aneurysm - giant aneurysm - high-flow bypass - intracavernous carotid aneurysm - large aneurysm - proximal occlusion - surgical treatment - trapping


Publication History

Article published online:
20 September 2022

© 2017. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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