Objective:To promote the operative successful rate and enlarge the operative range for tumors fixed to carotid artery. Methods:After preoperative evaluation of cerebral collateral circulation with digital subtraction angiography (DSA) and trans-cranial Doppler test (TCD), resection of tumor and carotid artery without artery reconstruction was applied to 14 patients with tumor fixed to carotid artery. Of them, 12 suffered from carotid body tumor and 2 from metastatic carcinoma of the neck. Results:After extracorporeal carotid pressure training with pediatric stermalretractor device (PSRD) for 30 days, TCD displayed excellent opening to anterior communication artery (AcoA) and posterior communication artery (PcoA) in all cases. The average cerebral perfusion flow rates of anterior cerebral artery (ACA) and middle cerebral artery (MCA) in the involved side were 40-56cm/s and 50-64cm/s respectively. Meanwhile, DSA displayed total and partial image development of ACA and MCA, which was considered to be eligible for surgery. Postoperative pathological examinations confirmed carotid body tumor in 12 cases, metastatic carcinoma from thyroid gland in one, and from mouth floor in another case. No intraoperative death and severe CNS complications occurred. Followup of the 14 patients for 4 to 15 years revealed that 2 cases of them died from tumor recurrence 2 years after operation. Conclusions:DSA and TCD play an essential role in the preoperative diagnosis and evaluation of compensatory ability of cerebral collateral circulations. Successful operation bases on precise preoperative evaluation, proper choice of surgical approach and procedure.