Open surgical repair of a loop-forming extracranial internal carotid artery aneurysm: a case report and literature review

Abstract Extracranial carotid artery aneurysms (ECCA) are rare vascular lesions that may be asymptomatic or present with compression-related symptoms, depending on their size and location. Etiologies include trauma, congenital anomalies, inflammation, atherosclerosis, or prior interventions. Major complications involve cranial nerve compression, rupture, and cerebral thromboembolism. Diagnostic and therapeutic management can be challenging, with treatment options including conservative follow-up, endovascular intervention, or open surgery. We present the case of a 76-year-old woman admitted with visual disturbances and a palpable mass on the left side of her neck. Radiological imaging revealed a 2 cm aneurysm with loop formation in the left internal carotid artery. The aneurysm was treated with open surgical aneurysmectomy and end-to-end anastomosis without grafting. Postoperative recovery was uneventful. Open surgical repair remains a safe and effective treatment, particularly in anatomically complex cases in which endovascular techniques are not feasible due to arterial tortuosity.