Long-term follow-up analysis of microsurgical clip ligation and endovascular coil embolization for dorsal wall blister aneurysms of the internal carotid artery

Brown, Mason A.; Guandique, Cristian F.; Parish, Jonathan; McMillan, Aubrey C.; Lehnert, Stephen J.; Mansour, Nassir M.; Tu, Manghui; Bohnstedt, Bradley N.; Payner, Troy D.; Leipzig, Thomas J.; DeNardo, Andrew J.; Scott, John A.; Cohen-Gadol, Aaron

doi:10.1016/j.jocn.2016.12.021

Cited by 11 publications

(3 citation statements)

References 17 publications

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“…However, in our study, small series for coiling alone reported a good rate of occlusion. 17,22 Indeed, our data showed that stent-assisted coiling was considered by most of the authors as the first-line treatment (about 32% of all cases), with 83% of complete/near-complete occlusion at final follow-up and a clinical outcome comparable with that for the other treatments. The rate of complications was also comparable except for the incidence of vasospasm, which was reported in a significantly higher percentage of cases (about 11%), though these data were not corrected for clinical status at admission.…”

Section: Coiling and Stent-assisted Coilingmentioning

confidence: 61%

Endovascular Treatment of Ruptured Intracranial Blister Aneurysms: A Systematic Review and Meta-analysis

Scerrati

Visani²,

Flacco

et al. 2020

AJNR Am J Neuroradiol

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Section: Coiling and Stent-assisted Coilingmentioning

confidence: 61%

Endovascular Treatment of Ruptured Intracranial Blister Aneurysms: A Systematic Review and Meta-analysis

Scerrati

Visani²,

Flacco

et al. 2020

AJNR Am J Neuroradiol

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“…The prevention of clip slippage depended on aneurysm location. Specifically, reinforcing with any wrapping material, clip-wrapping methods and placing blades parallel to carotid were proposed in blood blister-like aneurysms [21][22][23][24][25]. Whereas in cases of a clip slipped from ACoA aneurysm, the authors did not provide any suggestions for repair.…”

Section: Discussionmentioning

confidence: 99%

Late postoperative slippage of the cerebral aneurysm clip. A systematic review and meta-analysis

Szmuda¹,

Słoniewski²

2019

Eur J Trans Clin Med

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Background: A late clip slippage from the previously properly secured cerebral aneurysm is rarely observed. To date these complications have not pooled and evaluated using systematic review methodology. The objective was to report factors attributed to the late slippage of the aneurysm clip in the postoperative period. Materials and methods: All causes of postoperative clip slippage were systematically reviewed and analysed according to PRISMA Individual Patient Data protocol. Medline (PubMed), Embase, Cochrane, ISI Web of Knowledge and Google Scholar were searched for all relevant cases. Results: Systematic review of the literature yielded 105 original cases proving slipped clip in the postoperative period. The slipped clip caused bleeding in 53.8% of patients. The putative cause of clip slippage was provided in only 34.7% of the published cases. If a single clip was used, then complete clip slippage was noted more often (p=0.04). Multiple clipping and clip-wrapping techniques were postulated as ways to prevent postoperative clip slippage. Conclusions: The reason for late slippage of the aneurysm clip remains unexplained by most authors. Based on systematic reviewing, the use of tandem of clips prevents their late migration off the aneurysm. Clipping with wrapping or use of a single clip reinforced by any wrapping material seems a more durable solution.

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“…The treatment of these lesions is complicated and various treatment approaches, both endovascular and microsurgical, have been proposed. [1][2][3][4][5][6][7][8][9][10][11][12] Despite significant progress in endovascular and microsurgical treatment, no reliable management strategy has been established so far.…”

Section: Introductionmentioning

confidence: 99%

Microsurgical clipping and endovascular flow diversion of ruptured anterior circulation blood blister-like aneurysms

et al. 2018

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Background Detection and treatment of blister-like intracranial aneurysms as a source of subarachnoid hemorrhage (SAH) can be challenging. In the past the results of both microsurgical and endovascular treatment were difficult. We present our experience with the treatment of blister-like aneurysms in the acute phase of SAH using microsurgical clipping, endovascular parent vessel occlusion or flow diversion. Methods A retrospective analysis of the cases of eight consecutive patients presenting in the acute phase after SAH from an intracranial blister aneurysm was performed. The demographic data of the patients, aneurysm characteristics, the clinical results of the treatment and the follow-up examinations were recorded. Procedural safety margins and aneurysm occlusion on follow-up digital subtraction angiography were the main interest of this evaluation. Results Between January 2012 and November 2017 a total of eight ruptured blister aneurysms were treated in our center, six patients endovascularly. Five patients were treated in the acute phase of SAH, four by flow diversion. All endovascular procedures were feasible and no procedure-related complications were observed, especially no recurrent hemorrhage. In the first angiographic follow-up all blood blister-like aneurysms were completely occluded; two of the six patients treated by flow diverter implantation showed mild, transient intimal hyperplasia without clinical symptoms or the need for treatment. Conclusions Endovascular flow diversion is a viable option in the acute phase after SAH due to the rupture of a blister aneurysm. Implants with reduced thrombogenicity, obviating dual-platelet function inhibition, and flow diverters for vessel bifurcations would extend the indications for this treatment modality.

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Long-term follow-up analysis of microsurgical clip ligation and endovascular coil embolization for dorsal wall blister aneurysms of the internal carotid artery

Cited by 11 publications

References 17 publications

Endovascular Treatment of Ruptured Intracranial Blister Aneurysms: A Systematic Review and Meta-analysis

Endovascular Treatment of Ruptured Intracranial Blister Aneurysms: A Systematic Review and Meta-analysis

Late postoperative slippage of the cerebral aneurysm clip. A systematic review and meta-analysis

Microsurgical clipping and endovascular flow diversion of ruptured anterior circulation blood blister-like aneurysms

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