Stent-assisted Coiling vs. Flow Diverter for Treating Blood Blister-like Aneurysms

Lee, Jeongjun; Kim, Do-Hyung; Lee, Su Hwan; Moon, Jung Hyeon; Yang, Seung Man; Cho, Keun-Tae; Kim, Bo Hae

doi:10.1007/s00062-022-01160-3

Cited by 11 publications

(9 citation statements)

References 56 publications

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“…Since then, more and more studies have reported the results of FDs in BBAs treatment. A meta-analysis confirmed that compared with other vascular reconstruction strategies, FD treatment has a higher rate of long-term complete occlusion and a lower rate of aneurysm recanalization but similar complications and clinical outcomes ( 5 ). Therefore, an FD can be used as an important treatment modality, even in the acute stage of ruptured BBAs.…”

Section: Discussionmentioning

confidence: 88%

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Retreatment with a flow diverter for recurrent blood blister-like aneurysms after embolization: A single-center case series

Yan

Zhu

Hao³

et al. 2022

Front. Neurol.

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Background and purposeTreatment of blood blister-like aneurysms (BBAs) has been a significant challenge mainly due to their high recurrence rate even after stent-assisted coiling (SAC) embolization. This study aims to evaluate the safety and efficacy of treating recurrent BBAs after SAC with a flow diverter (FD).MethodsA retrospective series of patients with recurrent BBAs who underwent the retreatment with the FD from June 2018 to December 2021 was included to analyze perioperative safety and immediate postoperative and follow-up outcomes.ResultsThe study enrolled 13 patients with recurrent BBAs previously treated with SAC. Within previous stents, an FD was deployed for retreatment, including eight Tubridge FDs and five PEDs. The time interval between initial treatment and FD implantation was 14–90 days. A total of 11 cases were treated with a single FD alone; two cases were treated with further endovascular coiling embolization, followed by FD implantation. The angiographic follow-up (6–12 months) was available in 12 patients, and all 12 recurrent BBAs were completely occluded. No perioperative complication was detected, and no rebleeding was found during the clinical follow-up (6–36 months).ConclusionThe use of the FD to manage recurrent BBAs after SAC is technically feasible, safe, and effective. The key to the success of the procedure is to ensure that the FD stent is fully open and has good apposition with the previously implanted stent.

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Section: Discussionmentioning

confidence: 88%

“…A flow diverter (FD) is used in the treatment of BBAs and is associated with more favorable angiographic outcomes but also with complications and clinical outcomes, compared with SAC ( 5 ). However, for previously stented aneurysms, FD treatment had been reported to be less effective and prone to complications ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Retreatment with a flow diverter for recurrent blood blister-like aneurysms after embolization: A single-center case series

Yan

Zhu

Hao³

et al. 2022

Front. Neurol.

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“…FD stents have been used successfully in the treatment of ruptured BBAs [ 24 , 25 , 26 , 27 ]. A recent meta-analysis of BBAs treated with endovascular approaches, including FD and SAC, from 2009 to 2020 showed that FD had a higher long-term complete occlusion rate and lower aneurysm recanalization rate than SAC (89.26% vs. 70.26% and 4.54% vs. 25.38%, respectively) [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, Zhu and colleagues found that a single PED could offer better outcomes than overlapping PEDs during a review of 165 patients with BBAs [ 5 ]. Disruption of flow to the aneurysm can induce aneurysmal shrinkage and intrasaccular thrombosis, although such a process needs weeks or months to achieve total occlusion during which there is a high re-rupture risk [ 12 , 13 ]. In order to decrease the risk of rebleeding and re-rupture in the acute phase, better treatment is needed.…”

Section: Discussionmentioning

confidence: 99%

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Flow Diverter Device-Assisted Coiling Treatment for Cerebral Blister Aneurysm: A Single-Center Study

et al. 2023

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Although endovascular treatment is a promising approach, blood blister-like aneurysms (BBAs) still present treatment challenges. This study aimed to assess the effectiveness and safety of flow diverter device-assisted coiling (FDDAC) for the treatment of BBAs, which are broad based and friable with a high rebleeding risk. Eight patients (five females and three males) who presented with subarachnoid hemorrhages (SAH) due to BBA ruptures between May 2020 and May 2022 were retrospectively enrolled. All patients were treated by flow diverter device (Tubridge) adjunctive coil embolization using a semi-deploying technique. The demographic information, angiographic data, interval between admission and treatment, materials, therapy, clinical outcomes (including periprocedural and intraprocedural mortality and morbidity), and follow-up results of all patients were reviewed. The mean age of the patients with BBAs was 48.5 years (range 31–62 years); aneurysm sizes ranged from 2.2 × 1.7 mm to 4.6 × 3.2 mm, and the median Hunt–Hess score was 3. All aneurysms were completely closed at follow-up, and all 8 patients had excellent clinical outcomes (modified Rankin scores = 0–2) at discharge. Angiograms showed complete aneurysm occlusion after 6 months to 1 year. In addition, there were no cases of re-rupture, re-treatment, or recurrence of the aneurysms. FDDAC is safe to use in patients with BBAs and provides an alternative treatment option for this disease.

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A propensity score–matched study on the short-term outcome of ruptured blood blister-like aneurysm treated by microsurgery or endovascular surgery: a single-center study of 155 cases

Wen

Wang²,

Chen³

et al. 2022

Neurosurg Rev

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Stent-assisted Coiling vs. Flow Diverter for Treating Blood Blister-like Aneurysms

Cited by 11 publications

References 56 publications

Retreatment with a flow diverter for recurrent blood blister-like aneurysms after embolization: A single-center case series

Retreatment with a flow diverter for recurrent blood blister-like aneurysms after embolization: A single-center case series

Flow Diverter Device-Assisted Coiling Treatment for Cerebral Blister Aneurysm: A Single-Center Study

A propensity score–matched study on the short-term outcome of ruptured blood blister-like aneurysm treated by microsurgery or endovascular surgery: a single-center study of 155 cases

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