Revascularisation of Internal Carotid Artery Aneurysm near the Skull Base

A 51-year-old man presented with a pulsatile neck mass. Computed tomography angiography (CTA) revealed a right internal carotid aneurysm. No neurological symptoms occurred for more than 40 years in this patient, which indicated a possible congenital lesion worsened by secondary atherosclerosis. The aneurysm extended from the carotid bifurcation nearly to the base of the skull, and a normal internal carotid artery (ICA) segment was found before entering the carotid canal. The distal end of the extracranial ICA was exposed by transecting the digastric muscle and removing the styloid process during the procedures. The external carotid artery (ECA) was chosen as the inflow source in order to shorten the clamping time of the ICA. His recovery was uneventful, and the follow-up at 2 years revealed that carotid artery patency was obtained.