Abstract
Introduction
A carotid artery aneurysm is a rare yet significant finding. The purpose of this report is to describe the clinical presentation and sonographic findings of a post-endarterectomy aneurysm.
Case Report
A 65-year-old woman presented to our laboratory with an enlarging mass on the left side of her neck. Her medical history was significant for a left carotid endarterectomy approximately 1o years earlier.
Methods
A standard carotid Duplex evaluation was performed. Gray scale imaging on the left side of the neck revealed multiple irregular dilatations along the distal common carotid (CCA) and internal carotid arteries (ICA).
Results
The maximum diameter of the distal CCA measured 2.3cm compared with 0.8cm proximally. Areas of mixed echogenicity suggesting thrombus formation were observed in the CCA where the diameter of the artery was at its greatest. Color and spectral Doppler demonstrated highly turbulent flow in the aneurysmal area, along with an unremarkable velocity profile proximal and distal to this segment. The unusual irregularity of these dilatations along with no obvious neck characteristic of a pseudoaneurysm made it difficult to distinguish whether this lesion represented a false or true aneurysm. A computed tomography angiogram (CTA) demonstrated aneurysmal dilatation of the carotid artery with possible pseudoaneurysm formation at the level of the bifurcation. Angiography and subsequent surgical exploration revealed that the lesion was a true aneurysm. Repair was accomplished by insertion of a 6mm polytetrafluoroethylene interposition graft.
Conclusion
Color Duplex ultrasound was an accurate technique for identification of an uncommon carotid artery aneurysm.
Get full access to this article
View all access options for this article.