[Bilateral internal carotid aneurysms]

The authors discuss the treatment of five patients with bilateral carotid aneurysms and review the relevant literature. During the preoperative workup duplex scan, angiography and CT scan were obtained. The diameter of the aneurysms was in the range from 9 to 40 mm. Treatment plans were largely individualized. Two patients had bilateral and two had unilateral reconstructions carried out with end-to-end anastomosis. One patient was treated conservatively. In one case, a staged approach was chosen due to multiple aneurysms. As a postoperative complication, a reversible stroke was detected in one patient. All patients were followed up (between 3 to 14 years) by six monthly duplex scans. The authors suggest surgical treatment for carotid aneurysms with a diameter above 15 mm, increasing size, thrombotic plaques or neurological sings in order to avoid high risk complications (compression, rupture, embolisation).