Small, unruptured intracranial aneurysms and management of symptomatic carotid artery stenosis. North American Symptomatic Carotid Endarterectomy Trial Group

Of the 2885 patients participating in the North American Symptomatic Carotid Endarterectomy Trial, 90 (3.1%) had unruptured intracranial aneurysms (UIA), of which 96% had a diameter of less than 10 mm. During an average 5-year follow-up, only one patient had subarachnoid hemorrhage 6 days after carotid endarterectomy (CE). For patients with unrepaired UIA, the 5-year stroke risk was 10% after CE and 22.7% with best medical care. Both risks are similar to those of patients without UIA. The decision regarding CE probably should not be influenced by the presence of a small UIA.