Introduction: Aneurysms of the External Carotid Artery (ECA) and its branch vessels are rare vascular lesions with potentially devastating consequences. A comprehensive literature review regarding number, location, clinical presentation, and current treatment strategies of these aneurysms has not been published.
Methods: Using a multi-database search, a systematic review of multi-language literature was carried out. An initial search was performed by using the keywords “external carotid artery aneurysm,” “facial artery aneurysm,” “lingual artery aneurysm,” superficial temporal artery aneurysm,” and “middle meningeal artery aneurysm, clinical presentation, and treatment.” The corresponding incidence estimates were recorded in percentage of the total studied samples. All analysis was performed using STATA version 11.2 (StataCorp LP Texas USA). Finally, we proposed a treatment protocol for theses aneurysms.
Results: Our review of the literature revealed a total of 738 reported pseudoaneurysms of the ECA and its branches in 736 patients. We also found a total of 74 reported true aneurysms of the ECA and its branches in 74 patients. Surgery, endovascular, and percutaneous injection techniques were the most common treatment modalities.
Conclusions: Our systematic review of the literature showed 810 published cases of true and pseudoaneurysms of the ECA and its branches. This review also showed that both surgical and endovascular strategies are available for treatment of these aneurysms. While small asymptomatic true ECA aneurysms can be observed, pseudoaneurysms of the external carotid artery and its branches, once diagnosed, require treatment to prevent rapid expansion, which may in turn lead to rupture, stroke, cranial nerve impingement, pain, cosmetic disfigurement, or death. Finally, we introduce a comprehensive treatment protocol based on our experiences and this review of literature.
Patient Care: By providing a comprehensive management strategy to everybody, all patients will get the best treatment possible.
Learning Objectives: Frequency , clinical presentation and How to manage psuedo and true aneurysms of the ECA.