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. 2017 Nov 13;12(11):e0187479.
doi: 10.1371/journal.pone.0187479. eCollection 2017.

Prevalence of extracranial carotid artery aneurysms in patients with an intracranial aneurysm

V E C Pourier  1 , C J H C M van Laarhoven  1 , M D I Vergouwen  2 , G J E Rinkel  2 , Gert J de Borst  1
Affiliations

Prevalence of extracranial carotid artery aneurysms in patients with an intracranial aneurysm

V E C Pourier et al. PLoS One. .

Abstract

Background and purpose: Aneurysms in various arterial beds have common risk- and genetic factors. Data on the correlation of extracranial carotid artery aneurysms (ECAA) with aneurysms in other vascular territories are lacking. We aimed to investigate the prevalence of ECAA in patients with an intracranial aneurysm (IA).

Methods: We used prospectively collected databases of consecutive patients registered at the University Medical Center Utrecht with an unruptured intracranial aneurysm (UIA) or aneurysmal Subarachnoid hemorrhage (SAH). The medical files of patients included in both databases were screened for availability of radiological reports, imaging of the brain and of the cervical carotid arteries. All available radiological images were then reviewed primarily for the presence of an ECAA and secondarily for an extradural/cavernous carotid or vertebral artery aneurysm. An ECAA was defined as a fusiform dilation ≥150% of the normal internal or common carotid artery or a saccular distention of any size.

Results: We screened 4465 patient records (SAH database n = 3416, UIA database n = 1049), of which 2931 had radiological images of the carotid arteries available. An ECAA was identified in 12/638 patients (1.9%; 95% CI 1.1-3.3) with completely imaged carotid arteries and in 15/2293 patients (0.7%; 95% CI 0.4-1.1) with partially depicted carotid arteries. Seven out of 27 patients had an additional extradural (cavernous or vertebral artery) aneurysm.

Conclusions: This comprehensive study suggests a prevalence for ECAA of approximately 2% of patients with an IA. The rarity of the disease makes screening unnecessary so far. Future registry studies should study the factors associated with IA and ECAA to estimate the prevalence of ECAA in these young patients more accurately.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flowchart of 27 index patients with an IA and ECAA, CA and/or VA.
N = number of patients, UIA = non-ruptured intracranial aneurysm, SAH = subarachnoid hemorrhage, AVM = arteriovenous malformation, IA = intracranial aneurysm, ECAA = extracranial carotid aneurysm, CA = extradural cavernous carotid aneurysm, VA = extracranial vertebral aneurysm.
See this image and copyright information in PMC

References

    1. Welleweerd JC, den Ruijter HM, Nelissen BG, Bots ML, Kappelle LJ, Rinkel GJE, et al. Management of extracranial carotid aneurysm. Eur J Vasc Endovasc Surg 2015;50: 141–7. doi: 10.1016/j.ejvs.2015.05.002 - DOI - PubMed
    1. Donas KP, Schulte S, Pitoulias GA, Siebertz S, Horsch S. Surgical outcome of degenerative versus postreconstructive extracranial aneurysms. J Vasc Surg 2009; 49:93–98. doi: 10.1016/j.jvs.2008.08.006 - DOI - PubMed
    1. de Borst GJ, Welleweerd JC, Moll FL. Aneurysms of the extracranial carotid artery In: Thompson M, Boyle J, Brohi K, Cheshire N, Davies A et al. Oxford Textbook of Vascular Surgery, second edition. Oxford: Oxford University Press; 2016. p 462–67.
    1. Welleweerd JC, Nelissen BG, Koele D, de Vries JP, Moll FL, Pasterkamp G, et al. Histological analysis of extracranial carotid artery aneurysms. PloS One 2015;10: e0117915 doi: 10.1371/journal.pone.0117915 - DOI - PMC - PubMed
    1. De Jong KP, Zondervan PE, van Urk H. extracranial carotid artery aneurysms. Eur J Vasc Surg. 1989; 3 (6): 557–62. - PubMed