Safety of carotid endarterectomy associated with small intracranial aneurysms.

BACKGROUND: The incidence and outcome of combined carotid artery disease and intracranial aneurysm (ICA) are not well reported. METHODS: Ten patients with combined disease, ICA and symptomatic carotid artery disease, were identified in 209 consecutive angiograms. Five men and five women with a mean age of 68 years and the risk factors of diabetes, hypertension, smoking, cardiac disease, peripheral vascular disease, and hypercholesterolemia formed the basis for this study. RESULTS: Five patients with carotid endarterectomy (CEA) and arterial aneurysms less than 5 mm and five with carotid stenosis and ICA less than 6 mm were treated with Coumadin; one with combined disease left the hospital without treatment; and one with combined disease died preoperatively of a myocardial infarction. One patient with a 2 cm x 3 cm ICA and carotid had both operated on successfully. CONCLUSIONS: In this group of patients, CEAs were done safely in patients with ICAs less than 6 mm.