Procedural outcomes and follow-up of endovascular treatment for extracranial carotid artery aneurysms: A systematic review.
Roos A M van Heeswijk, Saskia I Willemsen, Constantijn E V B Hazenberg et al.
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In 30 seconds
This systematic review assessed procedural and follow-up outcomes of endovascular treatment (EVT) for extracranial carotid artery aneurysms. It included 14 observational studies involving 276 patients and 295 aneurysms. Technical success was 98.6%, while complete aneurysm exclusion was achieved in 87.3%. Periprocedural stroke occurred in 2.5% and procedure-related mortality in 0.4%. At a median follow-up of 16.6 months, mid-term patency was 93.9% and reintervention occurred in 3.2% of cases. The authors judged EVT feasible and apparently safe, while noting limitations in the evidence base.
Key findings
- Technical success was 98.6%, with complete aneurysm exclusion in 87.3%.
- Periprocedural stroke occurred in 2.5% and procedure-related mortality in 0.4%.
- At a median follow-up of 16.6 months, mid-term patency was 93.9% and reintervention occurred in 3.2% of cases.
- Outcomes were comparable across stent types.
Why it matters
ECAA treatment lacks standardized guidelines, and this review consolidates reported EVT outcomes across available studies. The high technical success and low reported complication rates suggest EVT is a feasible option in the studied populations. However, the findings do not establish long-term durability or comparative effectiveness, so they should be interpreted alongside the limited and heterogeneous evidence.
What to keep in mind
The evidence comprised small observational studies with moderate-to-high risk of bias, heterogeneous designs and outcome definitions, and short, variable follow-up.