Oblique Clip Technique via Anterior Temporal Approach for Blood Blister Aneurysm of Distal Portion of Internal Carotid Artery

Gurung, Pritam; Motoyama, Yasushi; Nakagawa, Ichiro; Park, Hun Soo; Hironaka, Yasuo; Park, Young Su; Ohnishi, Hideyuki; Nakase, Hiroyuki

doi:10.1016/j.wneu.2016.09.009

Cited by 2 publications

(4 citation statements)

References 19 publications

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“…When a BBA is treated with clipping, it is necessary 1) to pull intact vessel walls close to each other by pinching them over the fragile aneurysm dome and neck and 2) to prevent clip blades from slipping off after pinching 2, 3, 8, 28. If these 2 conditions were satisfied, a BBA could be repaired by a simple clipping without the procedure of wrapping as reported in several studies 4, 7, 25, 26, 28, 53, 54, 55, 56. There have been reports of other methods, including a method of directly suturing a BBA alone 57 or a method of suturing the BBA followed by clipping to augment the closure 53, 58, 59.…”

Section: Discussionmentioning

confidence: 99%

Clipping on Crossed Wrapping Method for Ruptured Blood Blister-Like Aneurysm of the Internal Carotid Artery: Technical Note and Long-Term Results

Nishi

Kaji

Koga³

et al. 2019

World Neurosurgery: X

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Background We have been performing the clipping on crossed wrapping (COCW) method using 2 strips of cotton on patients with an internal carotid artery blood blister-like aneurysm (IC-BLA). This method is reliable in preventing the clips from slipping off and the aneurysm walls from being damaged during clipping, and it enables more appropriate and safer clipping. Here we report the technical details of this method and the long-term outcomes of patients receiving this procedure. Methods Fifteen of 1275 (1.5%) patients with a ruptured cerebral aneurysm who received treatment at the Saiseikai Kumamoto Hospital during the period from January 1, 1999, to December 31, 2016, had an IC-BLA. All 15 patients were treated with COCW, except for the first patient, who was treated using a single strip of cotton. The long-term outcome of the treatment was analyzed. Results The mean follow-up period was 74 months. The first patient experienced rerupture of an aneurysm 10 days after the operation. No complications or regrowth of an aneurysm were observed in the remaining 14 patients during the follow-up period, except for 1 patient who received a reoperation for the regrowth of an aneurysm. As the final outcome, the numbers of patients with a Modified Rankin Score of 0, 3, and 6 were 13, 1, and 1, respectively. Conclusions It is suggested that COCW is a treatment that enables safe and long-term management of lesions in IC-BLAs.

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Section: Discussionmentioning

confidence: 99%

Clipping on Crossed Wrapping Method for Ruptured Blood Blister-Like Aneurysm of the Internal Carotid Artery: Technical Note and Long-Term Results

Nishi

Kaji

Koga³

et al. 2019

World Neurosurgery: X

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“…The ideal treatment of an intracranial aneurysm is to obliterate it, while flow in the vessels associated with the aneurysm is maintained. They can be occluded using surgical techniques such as direct clipping, trapping, wrapping and bypass (2,(5)(6)(7)(8)10,(15)(16) .…”

Section: Treatment Of Blister-like Aneurysmmentioning

confidence: 99%

“…IV -circumferential, where the lesion has an extension around the carotid (1,9) . Although saccular aneurysms have an intimal relation with major arterial junctions, the same cannot be expected with blister aneurysms (1,5,8,11,(15)(16)18) . In this type of lesion, they can be found in 65% of cases arising from the anteromedial carotid wall (1,13) .…”

Section: Introductionmentioning

confidence: 95%

“…If we compare them to the saccular aneurysm, it is noticed that they affect a younger population (1,3,13) . The first description was made by Sundt and Murphey in 1969, where they anatomically defined the aneurysm as a shallow and broad based or semi fusiform focal protrusion (1,3,4,6,11,(14)(15)(16) . The most common location is the supraclinoid internal carotid artery (ICA) (1,(3)(4)(5)7,(10)(11)(13)(14)(15)(17)(18) .…”

Section: Introductionmentioning

confidence: 99%

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Blister like aneurysm: a review about its surgical management / Aneurismas blister-like: uma revisão sobre seu manejo cirúrgico

Aguiar

Santos

et al. 2019

Arq Med Hosp Fac Cienc Med Santa Casa São Paulo

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Introduction: Blister aneurysms are of uncertain pathogenesis and are a vascular lesion located in the brain. Overall, they represent 0.3% - 1.0% of all intracranial aneurysms and 0.9% - 6.5% of ruptured intracranial aneurysms. They are associated with high morbidity and mortality. Even with the first description being from 1969, there is still debate in the literature about which type of treatment is the best: surgical or endovascular. In this review, we focus on the surgical management. Method: The authors performed a review of available surgical techniques used for blood blister-like aneurysms treatment. Pubmed database was used as search source introducing blister-like aneurysm and blister aneurysms as keywords. The most relevant articles and those that focused on surgical treatment techniques were selected. Discussion: The most used surgical methods are clipping, trapping, wrapping and bypass. As main features of each technique, we can highlight clipping with good efficiency, when there is good neck exposure; trapping being employed in ruptured aneurysm; wrapping for avulsion and bypass that promotes vascularization to the distal territory of the aneurysm. Conclusion: The endovascular method has shown to be promising and efficient. However, different surgical techniques are still being employed based on their efficiency when facing certain surgical scenarios.Keywords: Neurosurgery, Subarachnoid hemorrhage, Intracranial aneurysm, Endovascular proceduresRESUMOIntrodução: Aneurismas cerebrais blister-like são lesões vasculares de patogenia incerta. De modo geral, representam 0.3%-1.0% de todos aneurismas intracranianos e 0.9% - 6.5% dos aneurismas intracranianos que rompem. Estão associados a alta morbimortalidade. Mesmo com a primeira descrição sendo de 1969, ainda há debate na literatura sobre qual tipo de tratamento é o melhor: cirúrgico ou endovascular. Nessa revisão, focamos no tratamento cirúrgico. Métodos: Os autores realizaram uma revisão das técnicas cirúrgicas utilizadas para tratamento de aneurismas blister-like. A plataforma Pubmed foi utilizada para a pesquisa das palavras chaves “blister-like aneurysm” e “blister aneurysm”. Os artigos de maior relevância e aqueles que enfatizam as técnicas cirúrgicas foram selecionados. Discussão: Os métodos cirúrgicos empregados são clipagem, trapping, wrapping e bypass. Quanto às características de cada método, podemos salientar a eficácia da clipagem, quanto melhor for a exposição do aneurisma; o uso do trapping em situações de rompimento do aneurisma; wrapping para casos em que houve avulsão do aneurisma e by-pass que promove a vascularização distal ao aneurisma. Conclusão: O método endovascular tem se mostrado promissor e efetivo. No entanto, as diferentes técnicas cirúrgicas ainda são empregadas e defendidas devido a sua eficiência frente certos cenários cirúrgicos.Descritores: Neurocirurgia, Hemorragia subaracnóidea, Aneurisma intracraniano, Procedimentos endovasculares

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Oblique Clip Technique via Anterior Temporal Approach for Blood Blister Aneurysm of Distal Portion of Internal Carotid Artery

Cited by 2 publications

References 19 publications

Clipping on Crossed Wrapping Method for Ruptured Blood Blister-Like Aneurysm of the Internal Carotid Artery: Technical Note and Long-Term Results

Clipping on Crossed Wrapping Method for Ruptured Blood Blister-Like Aneurysm of the Internal Carotid Artery: Technical Note and Long-Term Results

Blister like aneurysm: a review about its surgical management / Aneurismas blister-like: uma revisão sobre seu manejo cirúrgico

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