Safety and Efficacy of Flow Diverter Treatment for Blood Blister–Like Aneurysm: A Systematic Review and Meta-Analysis

Zhu, Deyuan; Yan, Yazhou; Zhao, Puyuan; Duan, Guoli; Zhao, Rui; Liu, Jianmin

doi:10.1016/j.wneu.2018.06.123

Cited by 58 publications

(38 citation statements)

References 24 publications

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“…However, strong evidences on the safety and effectiveness of such devices with only one antiplatelet therapy are still lacking. Additionally, even though complete aneurysm occlusion is rarely obtained at the end of the procedure in flow diversion, data from the literature21 as well as our local experience22 show that dual antiplatelet therapy is still a reasonable option in patients treated with FDSs at the acute phase; the flow diversion, by redirecting the blood flow in the parent artery, probably reduces the stress exerted on the aneurysm's ! 14…”

mentioning

confidence: 96%

Preliminary Experience with Cangrelor for Endovascular Treatment of Challenging Intracranial Aneurysms

et al. 2019

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mentioning

confidence: 96%

Preliminary Experience with Cangrelor for Endovascular Treatment of Challenging Intracranial Aneurysms

et al. 2019

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“…Although BBAs are rare, comprising approximately 0.3% to 1.0% of intracranial aneurysms (IAs), 0.5 to 2.0% of ruptured IAs and 0.9% to 6.5% of ICAs, their propensity to cause spontaneous subarachnoid hemorrhage (SAH) has led to high morbidity and mortality [5][6][7]. Many treatment strategies have been reported in the literature, but the management of BBAs has proven to be intractable, and the optimal therapeutic strategy for BBAs is still under debate [5][6][7][8][9][10][11][12]. The microsurgical treatments for BBAs include direct clipping, wrapping, wrap-clipping, trapping, and revascularization.…”

Section: Introductionmentioning

confidence: 99%

“…The microsurgical treatments for BBAs include direct clipping, wrapping, wrap-clipping, trapping, and revascularization. Endovascular therapy can be performed with single coils, stent-assisted coils, multiple stents, and flow diversion (FD) [5,9,10,[12][13][14]. During the process of separating, exposing, or clipping the BBA, the aneurysm's neck is easily torn and can cause intraoperative bleeding, leading to a poor prognosis [13,15,16].…”

Section: Introductionmentioning

confidence: 99%

Current Knowledge of and Perspectives about the Pathogenesis of Blood Blister-like Aneurysms of the Internal Carotid Artery: A Review of the Literature

Zhai¹,

Hu²,

He³

et al. 2021

Int. J. Med. Sci.

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Blood blister-like aneurysms (BBAs) are rare and usually appear at nonbranching sites in the supraclinoid portion of the internal carotid artery (ICA). Because it is difficult to obtain histological specimens of the aneurysm wall and because experimental models are challenging to establish, the pathogenesis of BBAs remains uncertain. In this paper, we reviewed the diagnostic, radiological, and pathophysiological characteristics of patients with BBAs. We also summarized the existing evidence and potential mechanisms related to the causes of BBAs. Current evidence indicates that atherosclerosis and dissection are the main prerequisites for the formation of BBAs. Hemodynamics may play a role in the process of BBA formation due to the unique vascular anatomy of the supraclinoid ICA. Further research on histopathology and hemodynamics is warranted in this field.

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“…Endoluminal reconstruction using flow diversion represents a recently suggested safe treatment alternative for both BBAs and wide necked VSA as it does not require direct manipulation of the aneurysm [8]. Current data on flow diversion for this application, however, are limited [2, 6, 8, 9]. Here, we report a single center retrospective case series of flow diversion for BBAs and wide necked VSAs and evaluate safety and efficacy.…”

Section: Introductionmentioning

confidence: 99%

“…While various open-surgical and endovascular techniques have been suggested as possible treatment, the incidence of intra-operative rupture, and subsequent risk for morbidity and mortality is still high [2, 6, 7]. Endoluminal reconstruction using flow diversion represents a recently suggested safe treatment alternative for both BBAs and wide necked VSA as it does not require direct manipulation of the aneurysm [8]. Current data on flow diversion for this application, however, are limited [2, 6, 8, 9].…”

Section: Introductionmentioning

confidence: 99%

Flow diverter embolization device for endovascular treatment of ruptured blister and wide necked very small aneurysms

Ghorbani

Griessenauer

Wipplinger

et al. 2019

Heliyon

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PurposeRuptured blood blisters (BBA) and very small, wide necked aneurysms (VSA) remain challenging lesions to treat due to their small size, wide necks, and thin, fragile walls. In the present study, we reviewed our experience with these aneurysms treated by flow diversion.MethodsA total of 18 patients with hemorrhage due to a ruptured BBAs and VSAs, treated with flow diversion between July 2014 and March 2016 were included in this study. We analyzed clinical and radiographic outcomes.ResultsA total of 12 (66.7%) VSAs and 6 (33.3%) BBAs were treated with flow diversion. Fifteen (83.3%) and three (16.7%) aneurysms were located on the internal carotid artery and the basilar artery, respectively. On admission, a GCS score of 15 and WFNS grade 1 were found in 14 (77.7%) patients, 3 patients had an admission GCS of 13 and WFNS grade 2, one had an admission GCS of 8 and WFNS of 4. Fisher CT grades 2, 3, and 4 were observed in 11 (61.1%), 1 (5.6%), and 6 (33.3%) patients, respectively. Flow diversion was performed on average 5.6 days after onset of hemorrhage. 6 months post-intervention angiography showed complete obliteration of the aneurysms in all patients.ConclusionOur findings indicate that flow diversion in the acute and subacute phase of hemorrhage is a reliable treatment for reducing complications in patients with BBAs and VSAs. In patients with poor clinical presentation it might be reasonable to delay treatment until the first signs of recovery become apparent.

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Safety and Efficacy of Flow Diverter Treatment for Blood Blister–Like Aneurysm: A Systematic Review and Meta-Analysis

Cited by 58 publications

References 24 publications

Preliminary Experience with Cangrelor for Endovascular Treatment of Challenging Intracranial Aneurysms

Preliminary Experience with Cangrelor for Endovascular Treatment of Challenging Intracranial Aneurysms

Current Knowledge of and Perspectives about the Pathogenesis of Blood Blister-like Aneurysms of the Internal Carotid Artery: A Review of the Literature

Flow diverter embolization device for endovascular treatment of ruptured blister and wide necked very small aneurysms

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