Summary
Thirteen cases of aneurysm of the bifurcation of the internal carotid artery are described. Clinical history, symptoms, angiographic aspects and surgical treatment are all described. Ten patients had an operation: 1 ligature of the carotid in the neck, 6 clipping and 3 ligature of the aneurysmal neck. Surgery was followed by good results in 6 cases, poor results in 1 case and bad results in 3 cases.
The various surgical techniques available for this type of aneurysm are described and discussed on the basis of personal experience and of reports in the literature.
The suggestion is made that—on account of certain embryogenetic, statico-dynamic and surgical factors—aneurysms of the carotid bifurcation be regarded separately from other aneurysms of the internal carotid artery.
Zusammenfassung
Es werden 13 FÄlle mit Aneurysmen der Bifurkation der A. carotis interna beschrieben. Vorgeschichte, Symptome, angiographische Befunde und chirurgische Behandlung werden dargestellt. 10 Patienten wurden operiert: eine Unterbindung der Karotis am Hals, 6 Klippungen und 3 Ligaturen des Aneurysmahalses. Die chirurgische Behandlung führte in 6 FÄllen zu guten Ergebnissen, in einem Fall zu mÄ\igen Ergebnissen und in 3 FÄllen zu schlechten Ergebnissen.
Die verschiedenen chirurgischen Techniken, die bei dieser Art von Aneurysma zur Verfügung stehen, werden beschrieben und an Hand der eigenen Erfahrungen und der Berichte der Literatur besprochen.
Es wird die Ansicht vertreten, da\ — auf der Basis gewisser embryogenetischer, strömungsdynamischer und chirurgischer Gegebenheiten — die Aneurysmen der Karotisbifurkation von anderen Aneurysmen der Carotis interna unterschieden und als eigene Gruppe betrachtet werden müssen.
Résumé
Les auteurs analysent l'histoire, la symptomatologie, l'aspect angiographique de 13 cas d'anévrisme de la bifurcation de la carotide interne dont 10 furent traités chirurgicalement. Chez un patient la carotide fut ligaturée dans le cou; chez six patients on choisit le clippage du collet de l'anévrysme tandis que chez trois autres le collet de l'anévrysme fut ligaturé à la soie. Les résultats furent bons dans 6 cas, médiocres dans un cas et mauvais dans trois cas.
En tenant compte des cas rapportés dans la littérature et de leur propre expérience les auteurs engagent la discussion sur les méthodes de traitement chirurgical de ces anévrysmes.
On suggère de considérer les anévrysmes de la bifurcation de la carotide interne comme entité distincte des autres anévrysmes de la carotide interne en raison de leurs particularités embryologiques, staticodynamiques et chirurgicales.
Riassunto
Gli AA. descrivono 13 casi di aneurisma della biforcazione della carotide interna. Storia e sintomatologia clinica, aspetti angiografici e trattamento chirurgico vengono illustrati. Dieci pazienti furono operati: 1 con legatura della carotide al collo, 6 con “clippage” e 3 con legatura del colletto aneurismatico. L'intervento fu seguito da buoni risultati in 6 casi, risultati modesti in 1 caso e decesso in 3 casi.
Le possibili tecniche chirurgiche utilizzabili per questo tipo di aneurismi vengono descritte e discusse sulla base dell'esperienza personale e di quanto riportato in letteratura.
Gli AA. ritengono che — in ragione di alcuni particolari elementi embriogenetici, statico-dinamici e chirurgici — gli aneurismi della biforcazione debbano essere tenuti distinti dagli altri aneurismi della carotide interna.
Resumen
Los autores analizan las historias, sintomatología y aspecto angiográfico de 14 casos de aneurismas de la bifurcación de la carótida interna, de los cuales 10 fueron tratados quirÚrgicamente. En 1 enfermo se ligó la carótida en el cuello, en 6 se clipó el cuello del aneurisma, mientras que en los 3 restantes se ligó el cuello del aneurisma con seda. Los resultados han sido buenos en 6 casos, mediocres en 1 y malos en los 3 restantes.
Teniendo en cuenta los casos recogidos de la literatura y los de su propia experiencia los autores discuten sobre el tratamiento quirÚrgico de estos aneurismas.
Sugieren que los aneurismas de la bifurcación de la carótida debieran considerarse como una entidad distinta, diferentes a aquellos de la carótida interna, por sus particularidades embriológicas estáticas, estáticodinámicas y quirÚrgicas.
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Perria, L., Rivano, C., Rossi, G.F. et al. Aneurysms of the bifurcation of the internal carotid artery. Acta neurochir 19, 51–68 (1968). https://doi.org/10.1007/BF01402412
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DOI: https://doi.org/10.1007/BF01402412