Internal carotid artery aneurysm in the neck: management by gradual occlusion of the carotid artery with a Crutchfield clamp.

An elderly patient with a large internal carotid artery aneurysm high in the neck is reported. Optimal management by resection and restoration of continuity of the carotid was not felt possible due to the patient's age and the anatomy of the aneurysm. After demonstrating by angiography patency of the contralateral carotid artery and the circle of Willis, the involved carotid was gradually occluded by a Crutchfield clamp. The patient has done well following surgery and the aneurysm has shown progressive decrease in size. This technique is presented to demonstrate an alternate method of management of cervical carotid artery aneurysms when circumstances prevent more definitive treatment.