Blood blister–like aneurysms of the internal carotid artery trunk causing subarachnoid hemorrhage: treatment and outcome

Meling, Torstein R.; Sorteberg, Angelika; Bakke, Søren Jacob; Slettebø, Haldor; Hernesniemi, Juha; Sorteberg, Wilhelm

doi:10.3171/jns/2008/108/4/0662

Cited by 201 publications

(217 citation statements)

References 54 publications

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“…The authors advocated endovascular trapping in these cases due to the high recurrence rate, but another group reported very poor outcome with acute vessel sacrifice in the setting of acute SAH, mainly due to vasospasm. 26 Meckel et al 20 reported 12 blister or dissecting blisterlike posterior circulation ruptured aneurysms treated acutely with stent-assisted coiling in 11 and double stent placement alone in 1. Two patients rebled, 1 of whom died.…”

Section: Discussionmentioning

confidence: 99%

Immediate and Midterm Results following Treatment of Recently Ruptured Intracranial Aneurysms with the Pipeline Embolization Device

McAuliffe¹,

Wenderoth²

2011

AJNR Am J Neuroradiol

112

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Section: Discussionmentioning

confidence: 99%

Immediate and Midterm Results following Treatment of Recently Ruptured Intracranial Aneurysms with the Pipeline Embolization Device

McAuliffe¹,

Wenderoth²

2011

AJNR Am J Neuroradiol

112

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“…However, the trapping decreases or abolishes anterograde blood flow of the ICA. Meling and colleagues [8] reported that ICA trap made the patients with ruptured blister-like aneurysm poor outcome even though there was adequate collateral blood flow. They also mentioned that ICA trap could not be safely done when the cerebral vasospasm occurred after surgery.…”

Section: Treatment Of Ruptured Anterior Paraclinoid Aneurysmmentioning

confidence: 99%

“…They often presented with a "blister-like or blood blister-like" configuration. Blister-like aneurysms are characterized by a small hemispherical bulge on angiography and extremely fragile walls that are easily ruptured [1,8,9,10,13,14]. Clip surgery alone may provoke aneurysm avulsion and ICA laceration [4,13].…”

Section: Introductionmentioning

confidence: 99%

Ruptured anterior paraclinoid aneurysms

et al. 2010

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The purpose of this study was to evaluate cases of subarachnoid hemorrhage (SAH) from ruptured anterior ("dorsal") paraclinoid aneurysms. Anterior paraclinoid aneurysms are defined as aneurysms arising from the anterolateral wall of the proximal internal carotid artery without any relationship to an arterial branch. Between 1991 and 2008, a total of 159 patients with 169 paraclinoid aneurysms were treated at the Shinshu University Hospital and its affiliated hospitals. Retrospective analysis was carried out using charts, operation record, operation video, and neuroimagings. 26 patients had anterior paraclinoid aneurysms. Six patients presented with SAH. Three aneurysms were saccular and the others were blister-like aneurysms based on operative findings. Neck laceration or premature rupture frequently happened during the clipping surgery even though the aneurysm was saccular type. The treatment of a ruptured anterior paraclinoid aneurysm is quite difficult. Trapping and bypass would be recommended for such fragile aneurysms. Horiuchi et al. 3

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“…16,21,22,47,55 However, occlusion of a major vessel in an acute stage following subarachnoid hemorrhage is associated with poor prognosis. 33 Also, a balloon test occlusion may be difficult to assess when the patient is suffering from the neurological effects of a ruptured aneurysm. As for endovascular techniques, coil embolization of blister aneurysms also remains problematic and not suitable because of its associated risk of rupture and ischemia.…”

Section: Clipping Techniquesmentioning

confidence: 99%

“…All aneurysms in our series and those we found in the literature could be readily classified into 1 of these 4 types (Table 2). 1,2,4,6,7,9,10,[12][13][14][18][19][20][23][24][25][26][27][28][29][31][32][33]35,[39][40][41][42][43][44]47,[49][50][51][52]57 Each type presented distinctive surgical pitfalls, which required a different clip placement technique.…”

Section: Blister Aneurysm Classificationmentioning

confidence: 99%

Morphological aspects of blister aneurysms and nuances for surgical treatment

Bojanowski

Weil

McLaughlin

et al. 2015

JNS

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Blister aneurysms of the internal carotid artery (ICA) arise at a nonbranching site of the dorsal wall of the supraclinoid portion of the ICA. 1,17,30,31,36,38,45,48,53,54 These types of aneurysms are rare and their management remains difficult. Whether the approach to these aneurysms is surgical or endovascular, the literature shows a high mortality and morbidity rate due to their fragile wall with its high rate of rupture during treatment. 28,38,46,48 However, this grim prognosis is based on results that indiscriminately group all blister aneurysms together without taking into account the heterogeneous appearance of these lesions, thus making different treatment strategies difficult to assess. The first goal of this study was to ascertain whether blister aneurysm morphology played a role in the different pitfalls that may be encountered during surgery, and whether this morphology would require adapted surgical strategies. The second goal was to investigate whether any morphological differences could be categorized into abbreviatioN ICA = internal carotid artery. obJect Blister aneurysms of the supraclinoid part of the internal carotid artery (ICA) are known for their high morbidity and mortality rates related to treatment, regardless of whether the treatment is surgical or endovascular. However, this grim prognosis is based on results that indiscriminately group all blister aneurysms together without taking into account the heterogeneous appearance of these lesions. The goal of this study was 2-fold: to determine whether different blister aneurysm morphologies present different pitfalls, which would then require different surgical strategies, as well as to determine whether there are identifiable subgroups of these types of aneurysms based on morphology. methods The authors reviewed the charts, cerebral catheter angiograms, surgical reports, and intraoperative videos of all ICA blister aneurysms treated surgically at the Centre Hospitalier de l'Université de Montréal from 2005 to 2012 to investigate whether there was a relationship between morphology and pitfalls, and whether different surgical strategies had been used according to these pitfalls. During this review process the authors noted 4 distinct morphological aspects. These 4 aspects led to a review of the English and French literature on blister aneurysms in which imaging was available, to determine whether other cases could also be classified into the same 4 subgroups based on these morphological aspects. results The retrospective review of the authors' series of 10 patients allowed a division into 4 distinct subtypes: Type I (classic), Type II (berry-like), Type III (longitudinal), and Type IV (circumferential). These subtypes may at times be progressive stages in the arterial anomaly, and could represent a continuum. Each subtype described in this paper presented its own pitfalls and required specific surgical adaptations. Upon reviewing the literature the authors retained 35 studies involving a total of 61 cases of blister aneurysms, and all cases...

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Blood blister–like aneurysms of the internal carotid artery trunk causing subarachnoid hemorrhage: treatment and outcome

Cited by 201 publications

References 54 publications

Immediate and Midterm Results following Treatment of Recently Ruptured Intracranial Aneurysms with the Pipeline Embolization Device

Immediate and Midterm Results following Treatment of Recently Ruptured Intracranial Aneurysms with the Pipeline Embolization Device

Ruptured anterior paraclinoid aneurysms

Morphological aspects of blister aneurysms and nuances for surgical treatment

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