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Saudi Journal of Kidney Diseases and Transplantation
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LETTER TO THE EDITOR Table of Contents   
Year : 2010  |  Volume : 21  |  Issue : 6  |  Page : 1153-1154
Unilateral aneurysmal calcific dilatation of an extracranial portion of the internal carotid artery in a patient with end-stage renal disease


Department of Nephrology, Sri Venkateswara Institute of Medical Sciences, Tirupati, India

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Date of Web Publication4-Nov-2010
 

How to cite this article:
Sivakumar V, Parvatina S, Chennu K, Sainaresh V, Sivaramakrishna G. Unilateral aneurysmal calcific dilatation of an extracranial portion of the internal carotid artery in a patient with end-stage renal disease. Saudi J Kidney Dis Transpl 2010;21:1153-4

How to cite this URL:
Sivakumar V, Parvatina S, Chennu K, Sainaresh V, Sivaramakrishna G. Unilateral aneurysmal calcific dilatation of an extracranial portion of the internal carotid artery in a patient with end-stage renal disease. Saudi J Kidney Dis Transpl [serial online] 2010 [cited 2019 Oct 14];21:1153-4. Available from: http://www.sjkdt.org/text.asp?2010/21/6/1153/72315
To the Editor,

Aneurysmal dilatation of the extracranial por­tion of the internal carotid artery is rare. A middle-aged woman, a patient of chronic kid­ney disease secondary to amyloidosis, presen­ted with fluid overload and abnormal blood biochemistry: hemoglobin of 7 g/dL, serum creatinine of 9 mg/dL, Ca Χ P product of 48 mg 2 /dL 2 (10 Χ 4.8) and serum albumin of 3.7 g/dL, intact parathyroid hormone level of 121 pg/mL and 25 (OH) vitamin D of 19 ng/mL.. The chest X-ray of her neck and chest revealed proper position of the vascular access in addi­tion to a calcified dilated right internal carotid artery [Figure 1].
Figure 1 :X-ray neck AP view showing calcification and aneurysmal dilatation of the extracranial portion of the right internal carotid artery

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Trauma, infection, fibromuscular dysplasia, collagen disorders, Takayasu's arteritis, irradia­tion, Behcet's disease and congenital defects were noted in the differential diagnosis of the aneurysm, which may be symptomatic or asymp­tomatic; neck pain, stroke, transient ischemic attack, dysphagia and Horner's syndrome have been reported secondary to aneurysm. [1],[2]

When patients of end-stage renal disease are taken for internal jugular catheter placement, there is a possibility of injury to the great vessels of the neck when the procedure is performed blindly. A Doppler-guided catheter placement or pre-procedural thorough clinical examination of the neck and a plain X-ray some­times may bring out this abnormality. There­fore, this is to avoid inadvertent injury to the aneurysm, which may be catastrophic.

 
   References Top

1.Gouranga S, Narayan P. Aneurysm of extra cranial internal carotid artery. J Assoc Phys India 2009;57:(6)452.  Back to cited text no. 1
    
2.Sergi B, Alberti V, Paludetti G, Snider F. Extra cranial internal carotid artery aneurysm pre­senting as pharyngeal mass with dysphagia. J laryngol Otol 2006;120(2):e4.  Back to cited text no. 2
    

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Correspondence Address:
Vishnubotla Sivakumar
Department of Nephrology, Sri Venkateswara Institute of Medical Sciences, Tirupati
India
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PMID: 21060197

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This article has been cited by
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