Endovascular management of saccular extracranial internal carotid artery aneurysm using transcervical carotid approach and flow reversal

Transcervical endovascular management of saccular aneurysms of the extracranial internal carotid artery is an evolving treatment option. We report our experience during two decades in managing such a complex vascular scenario. Patients in this case series were symptomatic and had Eagle syndrome (elongated styloid processes in two cases and a calcified stylohyoid ligament in one case). All patients underwent endovascular stenting for expanding extracranial internal carotid artery saccular aneurysm using self-expandable covered stent grafts reinforced with a self-expanding nitinol stent. The approach was transcervical in all cases with cerebral protection by manual flow reversal.