Late complications of carotid ligation in the treatment of intracranial aneurysms

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Abstract
The results in 57 consecutive patients treated with carotid ligation for an intracranial aneurysm were analyzed to define the risks of late complications. The average age for the group was 46 yr. Most of the aneurysms [86%] were located on the internal carotid artery (ICA). The acute morbidity and mortality of the treatment and the natural history of the disease was 29%. Twenty-four patients were discharged with a common carotid artery (CCA) ligation; 21 patients with an ICA ligation. Three patients from each ligation group could not be located for review. The follow-up period for the 21 patients with CCA ligation ranged from 1-15 yr, with an average of 8.4 yr. For the 18 patients with ICA ligation it ranged from 2-19.5 yr, with an average of 12.5 yr. Excluding deaths from unrelated causes, 5 of the 21 patients with CCA ligation developed a late complication. Two patients had a transient ischemic attack (TIA). Two patients had a subarachnoid hemorrhage (SAH), 1 of which was fatal and was preceded by a TIA. Two patients developed monocular blindness. None of the patients had a stroke. Excluding deaths from unrelated causes, 5 of the 18 patients with ICA ligation developed a late complication. One patient had a fatal SAH, 3 patients had a TIA, 2 of which were followed by a stroke and 1 patient had a stroke in the cerebral hemisphere contralateral to the side of the carotid ligation.