Extracranial Severe Carotid Stenosis and Incidental Intracranial Aneurysms

Among 474 patients having 547 carotid endarterectomies (CEAs) over an 80-month period, 11 (2.3%) with symptomatic (n = 8) and asymptomatic (n = 3) severe (>70%) carotid stenosis had 12 asymptomatic intracranial aneurysms (IAs). None had postoperative stroke or died, and none had surgical or endovascular IA treatment before or after CEA. In an average 5-year follow-up, no patients had subarachnoid hemorrhage. Having an IA does not seem to be an additional risk factor for CEA, nor does CEA seem to increase the chance of IA rupture.