Management of carotid artery stenosis in patients with coexistent unruptured intracranial aneurysms

Tiziano Tallarita, Thomas J. Sorenson, Lorenzo Rinaldo, Gustavo S. Oderich, Thomas C. Bower, Fredric B. Meyer, Giuseppe Lanzino

Research output: Contribution to journalArticle

Abstract

OBJECTIVE Concomitant unruptured intracranial aneurysms (UIAs) are present in patients with carotid artery stenosis not infrequently and result in unique management challenges. Thus, we investigated the risk of rupture of an aneurysm after revascularization of a carotid artery in a contemporary consecutive series of patients seen at our institution. METHODS Data from patients who underwent a carotid revascularization in the presence of at least one concomitant UIA at our institution from 1991 to 2018 were retrospectively reviewed. Patients were evaluated for the incidence of aneurysm rupture within 30 days (early period) and after 30 days (late period) of carotid revascularization, as well as for the incidence of periprocedural complications from the treatment of carotid stenosis and/or UIA. RESULTS Our study included 53 patients with 63 concomitant UIAs. There was no rupture within 30 days of carotid revascularization. The overall risk of rupture was 0.87% per patient-year. Treatment (coiling or clipping) of a concomitant UIA, if pursued, could be performed successfully after carotid revascularization. CONCLUSIONS Carotid artery revascularization in the setting of a concomitant UIA can be performed safely without an increased 30-day or late-Term risk of rupture. If indicated, treatment of the UIA can take place after the patient recovers from the carotid procedure.

Original languageEnglish (US)
Pages (from-to)94-97
Number of pages4
JournalJournal of neurosurgery
Volume132
Issue number1
DOIs
StatePublished - Jan 1 2020

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Keywords

  • Carotid endarterectomy
  • Carotid stenosis
  • Growth
  • Rupture risk
  • Stenting
  • Unruptured intracranial aneurysm
  • Vascular disorders

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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