title: Carotid artery revascularization in patients with concomitant carotid artery stenosis and asymptomatic unruptured intracranial artery aneurysm.
abstract: BACKGROUND
  The incidence of concomitant carotid artery stenosis and unruptured intracranial aneurysm (UIA) has been reported to be between 3% and 5%. The rupture risk of UIA measuring <7 mm is very low according to International Study of Unruptured Intracranial Aneurysm data. However, there may be a potential risk of aneurysm rupture after carotid artery revascularization because of increased cerebral blood flow. The aims of this study were to investigate the incidence of concomitant UIA in patients who needed carotid artery intervention and to survey the incidence of aneurysm rupture after treatment.
  
  
  METHODS
  Between October 2004 and December 2009, 114 patients with severe carotid artery stenosis were treated in our hospital (69 carotid endarterectomies and 45 carotid artery stentings). Cerebral angiography and medical records were reviewed retrospectively.
  
  
  RESULTS
  Cerebral angiography revealed seven asymptomatic UIAs in six patients (5%, 6/114). Of them, four patients underwent carotid endarterectomy and two underwent carotid artery stenting. All patients were male, and the mean age of the patients was 72 years (range, 67-79 years). Aneurysm size ranged between 2.3 and 4.0 mm. Two patients had UIAs on the same side of the treated carotid artery, whereas others developed UIAs on the contralateral side. There was no periprocedural aneurysm rupture. During follow-up (mean: 18 months, 5-31 months), two patients died from other causes, and no rupture of aneurysm occurred in any of the patients.
  
  
  CONCLUSIONS
  In our series, the carotid artery revascularization did not have an effect on the natural course of small-sized asymptomatic UIA.
authors.affiliation: Department of Surgery, Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Bo-Yang
authors.initials: BY
authors.lastname: Suh
authors.forename: Woo-Sung
authors.initials: WS
authors.lastname: Yun
authors.forename: Woo-Hyung
authors.initials: WH
authors.lastname: Kwun
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction; D017130:Angioplasty / Q000009:adverse effects / Q000295:instrumentation; D058070:Asymptomatic Diseases; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D002533:Cerebral Angiography; D016894:Endarterectomy, Carotid / Q000009:adverse effects; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D056910:Republic of Korea; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome