Extracranial carotid aneurysms bridging gaps in diagnosis and treatment

Extracranial carotid artery aneurysms (ECAA) are uncommon and frequently overlooked conditions. This review seeks to encapsulate the prevailing insights on ECAA, focusing on its causes, clinical manifestations, diagnostic difficulties, and treatment alternatives. An extensive literature review was conducted, concentrating on studies that delve into the etiology, diagnostic processes, and management strategies for extracranial carotid aneurysms. Relevant articles published from 2000 to 2024 were sourced from databases including PubMed and Web of Science. ECAA is frequently asymptomatic and diagnosed incidentally, with pulsatile neck masses and cerebral ischemic events being the most common clinical presentations. Various etiologies, including atherosclerosis, infection, and trauma, contribute to the development of ECAA. Treatment strategies vary, ranging from conservative medical management to surgical and endovascular interventions, with no established guidelines (Central Illustration). ECAA remains a rare but significant clinical challenge due to the lack of consensus on its management. Further research is necessary to establish treatment guidelines and improve patient outcomes. Both surgical and endovascular options show promising results, but long-term data are needed. [Turk J Vasc Surg 2025; 34(1.000): 89-94]