Ruptured symptomatic internal carotid artery dorsal wall aneurysm with rapid configurational change. Clinical experience and management outcome: an original article

Lee, C.-C.; Hsieh, Tsung-Che; Wang, Y.-C.; Lo, Yu Lun; Lee, S.-T.; Yang, Tonghui

doi:10.1111/j.1468-1331.2010.03029.x

Cited by 30 publications

(21 citation statements)

References 22 publications

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“…Surgical treatment, as well as simple or stent-assisted endovascular coiling, has some limitations, as previously described in literature 3 6–9. If sufficient cross-flow is present, the best treatment remains occlusion of the carotid artery in the non-branching portion of the internal carotid artery10 11 or surgical trapping 12–15. Some authors proposed stent-in-stent assisted coiling to reduce the risk of recurrence 16 17.…”

Section: Discussionmentioning

confidence: 99%

Treatment of two blood blister-like aneurysms with flow diverter stenting

Consoli

Nappini

Renieri

et al. 2011

J NeuroIntervent Surg

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Section: Discussionmentioning

confidence: 99%

Treatment of two blood blister-like aneurysms with flow diverter stenting

Consoli

Nappini

Renieri

et al. 2011

J NeuroIntervent Surg

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“… 20) An aneurysm that initially presents as a blister type can show rapid morphological change to a saccular type along with rapid growth in size; 1) 7) 18) these aneurysms have been regarded as false aneurysms with extremely unstable walls, such as with BBAs. 9) While it has been suggested that such a morphological change could be caused by the growth and organization of a blood clot surrounding a focal wall defect, 18) it is also possible that a partial occlusion and recanalization may lead to development of an initial bulge in a blister type aneurysm. 7) Both of the current cases occurred in the right-sided ICA and appeared as true saccular-shaped aneurysms with extremely unstable walls and necks, which differ from the typical saccular type that has a firm neck.…”

Section: Discussionmentioning

confidence: 99%

“…Endovascular coil embolization is another treatment option for dorsal wall ICA aneurysm; however, because of the unstable aneurysmal wall and potential of incomplete packing with a residual neck, the risk of rupture during coiling is very high. 9) 19) 21) The endurance and effectiveness of coil embolization for management of dorsal wall ICA aneurysms remains controversial and dangerous; 7) 9) 21) Management of aneurysm regrowth and re-rupture of a dorsal wall ICA aneurysm by coil embolization has been reported. Good outcomes with reconstructive endovascular treatment using a stent-within-stent technique for BBA have been reported; 6) the authors suggested that healing and thrombosis is facilitated by the unstable aneurysm neck and reduction in flow impingement by multiple-stent insertion.…”

Section: Discussionmentioning

confidence: 99%

Combination Treatment for Rapid Growth of a Saccular Aneurysm on the Internal Carotid Artery Dorsal Wall: Case Report

Choi

Kim

Park

et al. 2014

J Cerebrovasc Endovasc Neurosurg

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Aneurysms arising from non-branching sites of the supraclinoid internal carotid artery (ICA) are considered rare, accounting for only 0.9-6.5% of all ICA aneurysms. They are thin-walled, broad-based, can easily rupture during surgery, and are referred to as dorsal, superior, anterior, or ventral wall ICA aneurysms, as well as blister-like aneurysms. Various treatment modalities are available for blister-like aneurysms, but with varying success. Here, we report on two cases of saccular shaped dorsal wall aneurysms. Both patients were transferred to the emergency department with subarachnoid hemorrhage because of an aneurysmal rupture. Computed tomography angiography and transfemoral cerebral angiography (TFCA) showed a dorsal wall aneurysm in the distal ICA. We performed clipping on the wrapping material (Lyodura®, temporal fascia). Follow-up TFCA showed rapid configuration changes of the right distal ICA. Coil embolization was also performed as a booster treatment to prevent aneurysm regrowth. Both patients were discharged without neurologic deficit. No evidence of aneurysm regrowth was observed on follow-up TFCA at two years. Dorsal wall ICA aneurysms can change in size over a short period; therefore, follow-up angiography should be performed within the short-term. In cases of regrowth, coil embolization should be considered as a booster treatment.

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“…All aneurysms in our series and those we found in the literature could be readily classified into 1 of these 4 types (Table 2). 1,2,4,6,7,9,10,[12][13][14][18][19][20][23][24][25][26][27][28][29][31][32][33]35,[39][40][41][42][43][44]47,[49][50][51][52]57 Each type presented distinctive surgical pitfalls, which required a different clip placement technique.…”

Section: Blister Aneurysm Classificationmentioning

confidence: 99%

Morphological aspects of blister aneurysms and nuances for surgical treatment

Bojanowski

Weil

McLaughlin

et al. 2015

JNS

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Blister aneurysms of the internal carotid artery (ICA) arise at a nonbranching site of the dorsal wall of the supraclinoid portion of the ICA. 1,17,30,31,36,38,45,48,53,54 These types of aneurysms are rare and their management remains difficult. Whether the approach to these aneurysms is surgical or endovascular, the literature shows a high mortality and morbidity rate due to their fragile wall with its high rate of rupture during treatment. 28,38,46,48 However, this grim prognosis is based on results that indiscriminately group all blister aneurysms together without taking into account the heterogeneous appearance of these lesions, thus making different treatment strategies difficult to assess. The first goal of this study was to ascertain whether blister aneurysm morphology played a role in the different pitfalls that may be encountered during surgery, and whether this morphology would require adapted surgical strategies. The second goal was to investigate whether any morphological differences could be categorized into abbreviatioN ICA = internal carotid artery. obJect Blister aneurysms of the supraclinoid part of the internal carotid artery (ICA) are known for their high morbidity and mortality rates related to treatment, regardless of whether the treatment is surgical or endovascular. However, this grim prognosis is based on results that indiscriminately group all blister aneurysms together without taking into account the heterogeneous appearance of these lesions. The goal of this study was 2-fold: to determine whether different blister aneurysm morphologies present different pitfalls, which would then require different surgical strategies, as well as to determine whether there are identifiable subgroups of these types of aneurysms based on morphology. methods The authors reviewed the charts, cerebral catheter angiograms, surgical reports, and intraoperative videos of all ICA blister aneurysms treated surgically at the Centre Hospitalier de l'Université de Montréal from 2005 to 2012 to investigate whether there was a relationship between morphology and pitfalls, and whether different surgical strategies had been used according to these pitfalls. During this review process the authors noted 4 distinct morphological aspects. These 4 aspects led to a review of the English and French literature on blister aneurysms in which imaging was available, to determine whether other cases could also be classified into the same 4 subgroups based on these morphological aspects. results The retrospective review of the authors' series of 10 patients allowed a division into 4 distinct subtypes: Type I (classic), Type II (berry-like), Type III (longitudinal), and Type IV (circumferential). These subtypes may at times be progressive stages in the arterial anomaly, and could represent a continuum. Each subtype described in this paper presented its own pitfalls and required specific surgical adaptations. Upon reviewing the literature the authors retained 35 studies involving a total of 61 cases of blister aneurysms, and all cases...

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Ruptured symptomatic internal carotid artery dorsal wall aneurysm with rapid configurational change. Clinical experience and management outcome: an original article

Cited by 30 publications

References 22 publications

Treatment of two blood blister-like aneurysms with flow diverter stenting

Treatment of two blood blister-like aneurysms with flow diverter stenting

Combination Treatment for Rapid Growth of a Saccular Aneurysm on the Internal Carotid Artery Dorsal Wall: Case Report

Morphological aspects of blister aneurysms and nuances for surgical treatment

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