Proximal carotid ligation for internal carotid aneurysms

✓ The results of proximal carotid ligation for internal carotid aneurysms in 106 patients over a 20-year period are presented. These confirm the belief that carotid ligation is a useful definitive procedure in patients with aneurysms on the internal carotid artery, including its bifurcation. Common carotid ligation is effective protection against recurrent hemorrhage, at the same time being safer than internal carotid ligation. Matas' test has limited applicability in patients being prepared for carotid ligation. Cerebral vasospasm seen on arteriograms, cerebral circulation studies with and without carotid compression, and intravascular pressure determinations at the time of surgery are more reliable methods to decide the timing, rate, and degree of occlusion of the vessel, and to decrease the incidence of postoperative ischemic complications.