Surgical management of carotid artery aneurysm with ball valve thrombus

Operative repair of extracranial carotid artery aneurysms has been infrequently reported. A unique case is presented in which an aneurysm of the cervical internal carotid artery contained a ball valve thrombus. The patient experienced transient ischemic attacks whenever a position was assumed which permitted occlusion of the internal carotid artery by the free floating thrombus. The aneurysm and thrombus were successfully resected and primary anastomosis of the internal carotid artery carried out to the common carotid artery. The patient has remained free of cerebrovascular ischemic symptoms for 18 months following operative repair. The previously reported surgical experience with extracranial carotid artery aneurysms is reviewed.