Application of the Willis Covered Stent in the Treatment of Blood Blister-Like Aneurysms: A Single-Center Experience and Systematic Literature Review

Liu, Lun-Xin; Zhang, Changwei; Xie, Xiaohua; Wang, Chaohua

doi:10.1016/j.wneu.2018.11.245

Cited by 22 publications

(28 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Blood-blisterlike aneurysms (BBAs) are a rare subtype of intracranial pseudoaneurysmal lesions that account for 0.5-2% of ruptured intracranial aneurysms and result in abnormally high morbidity and mortality [1,4,7]. They represent approximately 0.9-6.5% of all internal carotid artery (ICA) aneurysms [2,7].…”

Section: Introductionmentioning

confidence: 99%

Clip-wrapping of ruptured blood blister-like aneurysms of the internal carotid artery

Meling

Patet

2019

Neurosurg Rev

View full text Add to dashboard Cite

To evaluate the safety and validity of microsurgical Gore-Tex clip-wrapping for ruptured blood-blisterlike aneurysms (BBAs) of the internal carotid artery (ICA). METHODS: Single-surgeon series. Retrospective study. Data analyzed were patient age, sex, Hunt and Hess grade (H&H), Fisher grade, time from rupture to hospitalization, aneurysm size and location, collateral capacity of the circle of Willis, time from hospitalization to aneurysm repair, aneurysm obliteration, complications, and modified Rankin scale (mRS) at follow-up. RESULTS: Six patients (2 males, 4 females) with ICA BBAs underwent clip-wrapping between 2011 and 2016. Median age was 50.0 years (range 31.7-54.0). H&H was grade 1 or 2 in 5 patients and grade 4 in 1 patient. All aneurysms were small (≤0.3 cm), without relation to vessel bifurcations, and located anteromedially, anterolaterally and superomedially on the ICA trunk. Right side was most frequent (66%). All aneurysms could be clip-wrapped without intraoperative ruptures and all parent arteries could be preserved in the acute phase. Clipwrapping completely eliminated the BBAs in five patients, whereas one patient underwent additional stent-assisted coiling. There were no re-ruptures, delayed infarctions or deaths postoperatively. After a median follow-up of 57 months (range 20-90), outcome was favorable (mRS score 0-2) in all patients without radiographic signs of recurrences. CONCLUSIONS: Using the Gore-Tex clip-wrapping technique for ruptured ICA BBAs, the aneurysm could be treated without intraoperative ruptures or parent artery sacrifice in the acute phase. The outcomes were similar to other SAH patients and on follow-up, there were no aneurysm recurrences, indicating a durable long-term outcome.

show abstract

Section: Introductionmentioning

confidence: 99%

Clip-wrapping of ruptured blood blister-like aneurysms of the internal carotid artery

Meling

Patet

2019

Neurosurg Rev

View full text Add to dashboard Cite

show abstract

“…With the improvement in endovascular interventional devices, interventional therapy has gradually become mainstream in BBA treatment (5,11). Despite the lack of a uniform treatment guideline, various interventional treatment strategies have achieved satisfying outcomes, including WCSs, double porous stent-assisted coils, and flow diverters.…”

Section: Discussionmentioning

confidence: 99%

“…(4) no space-occupying lesions occur after WCSs placement (11,13,14). On the contrary, double overlapping porose stents rarely cause side branch acute occlusion and easily pass through tortuous vessels.…”

Section: Indicationmentioning

confidence: 99%

Safety and Efficacy of Endovascular Therapy for Blood Blister-Like Aneurysms: Willis Covered Stents and Double Stents Assistant Coils—A Single Center Cohort Study

Chang

Shen

et al. 2021

Front. Neurol.

View full text Add to dashboard Cite

Objective: To summarize and discuss the application of Willis covered stents (WCSs) and double stent-assisted coils in the treatment of blood blister-like aneurysms (BBAs).Materials and Methods: Thirty-two patients with BBAs treated from January 2015 to October 2020 were included in the study. Among them, 18 were treated using WCSs and 14 using double stents-assisted coils. The indications for treatment, perioperative findings, and postoperative follow-up results were collected and analyzed.Results: All 32 patients had successful stent deployments. Complete aneurysm occlusion was achieved in all 18 patients treated with WCSs immediately. WCS-related adverse events included 2 cases of mild vasospasm and 4 aggressive procedure-related vasospasms during WCS deployment, a case of dissection after WCS deployment, and 1 death due to ipsilateral temporal lobe rebleeding at the sixth day after WCS deployment. In patients treated with double stent-assisted coils, there were 3 cases of neck remnants, 1 acute occlusion of the ipsilateral MCA branch, and 4 mild procedure-related intraoperative vasospasms. The mean follow-up period was 4.2±1.6 months (range 3–6 months). Follow-up imaging data were available for 25 patients (78.1%). In the first postoperative angiographic follow-up, all BBAs were completely occluded. Mild asymptomatic stent stenosis was observed in 3 patients treated with WCSs. Follow-up examination at 6 months after the employment of WCSs showed that the modified Rankin score (mRs) was 0 in 6 patients, 1 in 5 patients, 2 in 3 patients, 3 in 1 patient, 4 in 2 patients, and 6 in 1 patient. After treatment with double stents-assisted coils, the mRs was 0 in 4 patients, 1 in 5 patients, 2 in 3 patients, and 4 in 2 patients.Conclusions: WCSs and double stent-assisted coils for the treatment of BBAs are both safe and efficient. WCSs provide a higher rate of immediate occlusion; however, there was no significant difference in the long term.

show abstract

“…Covered stent may more effective to prevent rebleeding, but has disadvantage on preservation of the branch arteries. 18) Flow…”

Section: Discussionmentioning

confidence: 99%

Endovascular Trapping for Ruptured Blood Blister-Like Aneurysm of the Internal Carotid Artery: A Case Report and Review of the Literature

Hayashi

Matsunaga

Hayashi

et al. 2021

JNET

View full text Add to dashboard Cite

Rupture of blood blister-like aneurysm (BBA) of the internal carotid artery (ICA) may result in fatal subarachnoid hemorrhage (SAH). Open surgery including bypass surgery has been performed to treat the aneurysm. Recently, endovascular treatment is developing for the treatment of cerebral aneurysm. Here, we report a case of ruptured BBA of the ICA, treated by endovascular trapping and review the literatures.Case Presentation: A 37-year-old woman was brought to our hospital to treat SAH. Computed tomography (CT) angiography showed no apparent cause of the hemorrhage except for the minor dilation of the C2 portion of the left ICA.After 3 days, the CT angiography demonstrated progression of the dilation with the formation of a bleb. Evaluating collateral circulation through anterior communicating artery, endovascular trapping of the ICA was performed. Although she suffered minor ischemic stroke postoperatively, the symptoms recovered completely and discharged without neurological deficit.Review of Literatures: we reviewed the 11 cases of ruptured BBA treated by endovascular trapping. The results of ICA occlusion based on the evaluation of collateral circulation were satisfactory because rebleeding as well as regrowth of the aneurysm were prevented. However, hemodynamic compromise and treatment for vasospasm following SAH are considered. Conclusion:Rebleeding from BBA of the ICA should be prevented first and ischemic complication is avoided secondary.Endovascular trapping following evaluation of the collateral circulation is definitive treatment of BBA of the ICA. Keywords▶ internal carotid artery aneurysm, anterior wall blister-like aneurysm, subarachnoid hemorrhage, endovascular parent artery occlusion This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License.

show abstract

Application of the Willis Covered Stent in the Treatment of Blood Blister-Like Aneurysms: A Single-Center Experience and Systematic Literature Review

Cited by 22 publications

References 29 publications

Clip-wrapping of ruptured blood blister-like aneurysms of the internal carotid artery

Clip-wrapping of ruptured blood blister-like aneurysms of the internal carotid artery

Safety and Efficacy of Endovascular Therapy for Blood Blister-Like Aneurysms: Willis Covered Stents and Double Stents Assistant Coils—A Single Center Cohort Study

Endovascular Trapping for Ruptured Blood Blister-Like Aneurysm of the Internal Carotid Artery: A Case Report and Review of the Literature

Contact Info

Product

Resources

About