Stent-assisted coil embolization of ruptured supraclinoid blood blister-like aneurysm of internal carotid artery

B, Yu; Zheng, Jie; Hong, Yang; Chen, Liang‐Yu; Xi, Zhuo; Yu, Miao; Que, Zhongyou; Liu, Yunhui

doi:10.5137/1019-5149.jtn.7657-12.2

Cited by 12 publications

(8 citation statements)

References 21 publications

(47 reference statements)

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“…This confirms that, despite a spectrum of treatment strategies for ruptured BBAs, their optimal management still remains uncertain 4 6 8 13 16 19 22 30. Besides confirming the above well-known opinion, our study diminishes the value of the combined application of stent and coils.…”

Section: Discussionsupporting

confidence: 82%

“…The third systematic review comprised an unselected series so the results cannot be applied solely to ruptured aneurysm conditions 14. Other authors of pooled studies applied novel therapeutic concepts in ruptured BBAs (eg, expanding the oversized stent as monotherapy,14 22 stent-assisted Onyx embolization8 13) and proved the superiority of using multiple stents over a single stent16 or decreased the role of stent-assisted coiling 30. In summary, one-quarter of the authors advocated FDS, despite not comparing them with other methods.…”

Section: Discussionmentioning

confidence: 99%

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Towards a new treatment paradigm for ruptured blood blister-like aneurysms of the internal carotid artery? A rapid systematic review

Szmuda

Słoniewski

Waszak

et al. 2015

J NeuroIntervent Surg

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Towards a new treatment paradigm for ruptured blood blister-like aneurysms of the internal carotid artery? A rapid systematic review

Szmuda

Słoniewski

Waszak

et al. 2015

J NeuroIntervent Surg

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“…There are some terminal and smaller ischemic events cannot be reflected by angiography during the surgery. In the postoperative period, patients may experience neurological deficits with different degrees [ 17 ]. In the present study, 1 patient experienced severe motor aphasia after surgery.…”

Section: Discussionmentioning

confidence: 99%

Clinical Study on Complications of Intracranial Ruptured Aneurysm Embolization by Stent-Assisted Coil

et al. 2018

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BackgroundThe aim of this study was to retrospectively analyze the incidence of complications of intracranial complex aneurysms embolization by stent-assisted coils, and to investigate the causes of complications and corresponding treatment methods.Material/MethodsA total of 71 patients with subarachnoid hemorrhage (SAH) underwent stent-assisted coil embolization from 2015 to 2018 were enrolled in this study. Among them, 59 cases were single aneurysm, 12 cases were multiple aneurysms (11 cases with 2 aneurysms and 1 case with 3 aneurysms), for a total of 84 aneurysms. All enrolled patients received stent angioplasty except for 1 case.ResultsThere were 62 aneurysms (73.81%) treated with complete tamponade, 21 aneurysms (25.00%) treated with near-total tamponade and 1 aneurysm (1.19%) treated with partial tamponade. All aneurysms were evaluated based on GOS (Glascow outcome scale): 55 cases had GOS of 5 scores, 12 cases had GOS of 4 scores, 3 cases had GOS of 3 scores, and 1 case had GOS of 1 score. There were 67 SAH patients with good prognosis (GOS of 4–5 scores). In our study, the incidence of complications was 12.7%. Three cases experienced acute thrombosis, 2 cases experienced aneurysm rupture during embolization, and 1 case experienced postoperative focal ischemic changes with mild neurological deficits.ConclusionsStent-assisted coil embolization is safe, effective, and feasible for the treatment of intracranial ruptured aneurysms. Patients had a favorable outcome of as high as 94.4%. However, clinical skills should be improved to reduce the occurrence of complications. Prompt and timely treatment for complications of intracranial ruptured aneurysm is also of great significance.

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“…In the acute period, ruptured BBAs have a shallow sac and a very fragile neck, which makes simple coiling difficult and stent-assisted coil therapy necessary 46. Moreover, the stent can provide the bridge by which vascular endothelial cells can cover the BBA neck 47.…”

Section: Endovascular Treatment To Repair the Supraclinoid Icamentioning

confidence: 99%

Current status of the treatment of blood blister-like aneurysms of the supraclinoid internal carotid artery: A review

Ji¹,

Guo²,

Huang³

et al. 2017

Int. J. Med. Sci.

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Currently, the treatment of blood blister-like aneurysms (BBAs) of the supraclinoid internal carotid artery (ICA) is challenging and utilizes many therapeutic methods, including direct clipping and suturing, clipping after wrapping, clipping after suturing, coil embolization, stent-assisted coil embolization, multiple overlapping stents, flow-diverting stents, covered stents, and trapping with or without bypass. In these therapeutic approaches, the optimal treatment method for BBAs has not yet been defined based on the current understanding of BBAs of the supraclinoid ICA. Therefore, in this study, we aimed to review the literature from PubMed to discuss and analyze the pros and cons of the above approaches while adding our own viewpoints to the discussion. Among the surgical methods, direct clipping was the easiest method if the compensation of the collateral circulation of the intracranial distal ICA was sufficient or direct clipping did not induce stenosis in the parent artery. In addition, the clipping after wrapping technique should be chosen as the optimal surgical modality to prevent rebleeding from these lesions. Among the endovascular methods, multiple overlapping stents (≥3) with coils may be a feasible alternative for the treatment of ruptured BBAs. In addition, flow-diverting stents appear to have a higher rate of complete occlusion and a lower rate of retreatment and are a promising treatment method. Finally, when all treatments failed or the compensation of the collateral circulation of the intracranial distal ICA was insufficient, the extracranial-intracranial (EC-IC) arterial bypass associated with surgical or endovascular trapping, a complex and highly dangerous method, was used as the treatment of last resort.

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Stent-assisted coil embolization of ruptured supraclinoid blood blister-like aneurysm of internal carotid artery

Abstract: Although several different techniques have been proposed by leading centers across the world, no consensus has been reached on the safest treatment modality due to poor clinical outcomes (12,(14)(15)(16). We present our experience in treating BBLAs with stent-assisted coil embolization.

Cited by 12 publications

References 21 publications

Towards a new treatment paradigm for ruptured blood blister-like aneurysms of the internal carotid artery? A rapid systematic review

Towards a new treatment paradigm for ruptured blood blister-like aneurysms of the internal carotid artery? A rapid systematic review

Clinical Study on Complications of Intracranial Ruptured Aneurysm Embolization by Stent-Assisted Coil

Current status of the treatment of blood blister-like aneurysms of the supraclinoid internal carotid artery: A review

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