Bilateral Extracranial Internal Carotid Artery Aneurysms in a Patient with Marfan Syndrome: Case Report and Review of the Literature

Introduction Aneurysms of the extracranial carotid artery are rare. They are often asymptomatic but can lead to disabling stroke. This report describes a case of bilateral internal carotid artery aneurysms in a patient with Marfan syndrome. Report A 65 year old woman with Marfan syndrome presented with an asymptomatic swelling in the right anterior triangle of the neck. Imaging revealed bilateral extracranial fusiform internal carotid artery aneurysms. Staged open repair was performed. The right side was repaired by aneurysm excision and primary end to end anastomosis. The left side was repaired with a great saphenous vein interposition graft. The patient is free from aneurysm related complications at six years, although recurrent dilatation is present on surveillance. Discussion Internal carotid aneurysms can be managed successfully by open repair. In patients with connective tissue disorders surveillance is required to monitor for post-operative aneurysmal dilatation.