Endovascular coil embolization for saccular-shaped blood blister-like aneurysms of the internal carotid artery

Matsubara, Noriaki; Miyachi, Shigeru; Tsukamoto, Nobuhiro; Izumi, Tohru; Naitô, Takeshi; Haraguchi, Kenichi; Wakabayashi, Toshihiko

doi:10.1007/s00701-010-0898-9

Cited by 45 publications

(45 citation statements)

References 23 publications

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“…BBA of the internal carotid artery is a rare lesion arising in the anterior or dorsal wall of a nonbranching segment of the internal carotid artery. In images, it is characterized by a small size, semi-spherical shape, wide-necked swelling, and irregular protrusion, [1][2][3] and is classified pathologically as a type of false aneurysm. 1,4,5) Common saccular aneurysms that cause subarachnoid hemorrhage are so-called true aneurysms, and as their wall consists of one to two layers of the normal blood vessel, they can be treated by clipping and coil embolization.…”

Section: Discussionmentioning

confidence: 99%

“…In images, it is characterized by a small size, semi-spherical shape, wide-necked swelling, and irregular protrusion, [1][2][3] and is classified pathologically as a type of false aneurysm. 1,4,5) Common saccular aneurysms that cause subarachnoid hemorrhage are so-called true aneurysms, and as their wall consists of one to two layers of the normal blood vessel, they can be treated by clipping and coil embolization. However, as false aneurysms are lesions in which the defect of the vascular wall is covered by thin fibrous tissue alone, 5) the risk of intraoperative bleeding and re-bleeding is high if they are treated similarly to true aneurysms.…”

Section: Discussionmentioning

confidence: 99%

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A Case of Good Outcome in Endovascular Treatment against an Undecided in True or Pseudo Aneurysm

Nonaka

Shoda

Kato

et al. 2017

JNET

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Objective: We report a case in which coil embolization was selected for an aneurysm that caused subarachnoid hemorrhage but was difficult to judge whether it was true or false.Case Presentations: A 78-year-old woman presented with severe subarachnoid hemorrhage. A wide-necked aneurysm was observed in the dilated internal carotid artery. We suspected senile atherosclerotic change, but blood blister-like aneurysm was also considered possible from the aneurysm morphology and dilation of the parent artery. Conservative treatment was initially selected, but as enlargement was noted in part of the aneurysm, coil embolization was performed as an emergency procedure, resulting in a stable postoperative course. Conclusion:In case of urgency, endovascular treatment may be a permissible option when the judgment of whether the aneurysm is true or false is difficult.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Case of Good Outcome in Endovascular Treatment against an Undecided in True or Pseudo Aneurysm

Nonaka

Shoda

Kato

et al. 2017

JNET

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“…These 4 subtypes may at times be stages in the evolutionary process, as observed regularly in the clinical setting. 10,29,49 In fact, blister aneurysms are easily missed on the first angiography, where sometimes a questionable bulge can be retrospectively identified. In such cases, a second angiography performed 3 to 14 days later reveals their rapid evolution, making the diagnosis obvious (Table 2) and adding evidence that one may be involved with a continuum.…”

Section: Discussionmentioning

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%

“…As for endovascular techniques, coil embolization of blister aneurysms also remains problematic and not suitable because of its associated risk of rupture and ischemia. 29,42 The use of flow diversion devices, such as the Pipeline (Covidien) and SILK (Balt Extrusion) devices, has been deemed a technically safe and feasible alternative. 3,5,8,15,26,37,56 However, the aneurysm is not always immediately occluded, leading to the potential risk of rebleeding.…”

Section: Clipping Techniquesmentioning

confidence: 99%

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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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Open Treatment of Cerebral Aneurysms in the Endovascular Age

Jabre

McElenney

Nakaji

2022

Endovascular Surgery of Cerebral Aneurysms

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Endovascular coil embolization for saccular-shaped blood blister-like aneurysms of the internal carotid artery

Abstract: Endovascular coil embolization can be considered as an alternative treatment option for selective saccular-shaped BBAs.

Cited by 45 publications

References 23 publications

A Case of Good Outcome in Endovascular Treatment against an Undecided in True or Pseudo Aneurysm

A Case of Good Outcome in Endovascular Treatment against an Undecided in True or Pseudo Aneurysm

Morphological aspects of blister aneurysms and nuances for surgical treatment

Open Treatment of Cerebral Aneurysms in the Endovascular Age

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