A novel approach to high-grade carotid stenosis with concomitant extracranial carotid aneurysms using TransCarotid Artery Revascularization.

Abstract We present the novel application of transcarotid artery revascularization (TCAR) in two high-risk patients with high-grade internal artery stenosis and concomitant atherosclerotic extracranial carotid artery aneurysms (ECAA). ECAAs account for less than 1% of arterial aneurysms and are usually clinically silent at presentation. Historically, the treatment of ECAAs has been via open reconstruction or stent grafting. TCAR is an effective alternative for carotid revascularization in high-risk patients that have high-grade carotid stenosis, but has not been widely used for aneurysmal management. The following two cases depict our management of concomitant carotid stenoses and ECCA with TCAR.