Direct attack on carotid ophthalmic and large internal carotid aneurysms

Some cases of carotid-ophthalmic and large internal carotid aneurysms successfully excluded from the carotid circulation by direct approach are presented. The principal anatomical and clinical features of the two groups of aneurysms, together with the technique used, are described. It is concluded that direct attack is the treatment of choice because it ensures exclusion of the aneurysm, permits sparing of internal carotid artery and removal of the aneurysmal sac where it compresses adjacent nervous structures.