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Blister aneurysm

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https://www.readbyqxmd.com/read/28927911/characteristics-of-blood-blister-like-aneurysms-with-a-saccular-shape-appearance
#1
Hirofumi Nishikawa, Shigetoshi Shimizu, Hideki Nakajima, Yotaro Kitano, Takanori Sano, Genshin Mouri, Fumitaka Miya, Hidenori Suzuki
BACKGROUND: Blood blister-like aneurysms (BBAs) are a subgroup of aneurysms located on non-branching sites of the internal carotid artery (ICA) and characterized by small size, a fragile wall, and a poorly defined broad-based neck. Both direct surgery and endovascular treatment for BBA are often challenging. Some of them were reported to look like a true saccular aneurysm, and the misdiagnosis of BBA might result in catastrophic outcomes. The purpose of this study is to clarify the clinical and intraoperative findings of saccular BBAs...
September 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28819696/what-are-the-treatment-options-for-blister-like-aneurysms
#2
REVIEW
Torstein R Meling
Treatment of blood blister-like aneurysms (BBAs) of the supraclinoidal internal carotid artery (ICA) is challenging and the optimal treatment is yet to be defined. The treatment options for ICA BBAS are microsurgery, endovascular therapy, or a combination of the two. The microsurgical armamentarium consists mainly of direct aneurysm clipping with or without protective EC-IC bypass, clip-wrapping, or trap ligation with ICA sacrifice with or without EC-IC bypass. The endovascular treatment options are mainly endovascular ICA ligation, multiple overlapping stents (≥ 3) with or without coiling, covered stents, or flow diverters...
August 17, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28758550/treatment-of-ruptured-blood-blister-aneurysms-using-primary-flow-diverter-stenting-with-considerations-for-adjunctive-coiling-a-single-centre-experience-and-literature-review
#3
Cunli Yang, Agnes Vadasz, István Szikora
Objective The objective of this article is to conduct a single-centre evaluation and quick literature review of the effectiveness of primary flow-diverter (FD) treatment of ruptured blood blister aneurysms (BBAs), with additional relevance of adjunctive coiling. Methods Patients presenting with subarachnoid haemorrhage (SAH) due to ruptured BBAs and subsequently treated with FDs were retrospectively selected from June 2010 to January 2017. Treatment techniques, angiographic data on occlusion rates and procedural success as well as clinical outcomes using the modified Rankin Scale (mRS) were collated...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28758549/pipeline-embolization-device-retraction-and-foreshortening-after-internal-carotid-artery-blister-aneurysm-treatment
#4
Jeremy J Heit, Nicholas A Telischak, Huy M Do, Robert L Dodd, Gary K Steinberg, Michael P Marks
Background Subarachnoid hemorrhage (SAH) secondary to rupture of a blister aneurysm (BA) results in high morbidity and mortality. Endovascular treatment with the pipeline embolization device (PED) has been described as a new treatment strategy for these lesions. We present the first reported case of PED retraction and foreshortening after treatment of a ruptured internal carotid artery (ICA) BA. Case description A middle-aged patient presented with SAH secondary to ICA BA rupture. The patient was treated with telescoping PED placement across the BA...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28720742/-two-cases-of-ruptured-blood-blister-like-aneurysm-treated-with-x-ray-angiography-perfusion-xap-analysis
#5
Shoichi Tani, Hirotoshi Imamura, Katsunori Asai, Kampei Shimizu, Hidemitsu Adachi, So Tokunaga, Takayuki Funatsu, Mikiya Beppu, Keita Suzuki, Hiromasa Adachi, Tomohiro Okuda, Yuichi Matsui, Yasunori Yoshida, Shuhei Kawabata, Ryo Akiyama, Kazufumi Horiuchi, Nobuyuki Sakai
Two cases of ruptured blood blister-like internal carotid artery aneurysms for which low flow bypass was sufficient to attain successful treatment of trapping are reported. In the acute stage of rupture, it is troublesome to perform accurate examinations of tolerance to ischemia like balloon occlusion test(BOT)for estimating the required amount of bypass flow. In our cases, X-ray angiography perfusion(XAP)analysis was introduced, which could be performed in a couple dozen seconds without room-to-room transfer of patients, following the ordinary examination of diagnostic digital subtraction angiography...
July 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28706764/neuroradiological-endovascular-intervention-for-diplopia-in-a-case-of-aneurysmal-aberrant-regeneration-of-the-third-nerve
#6
Anupam C A Rao, Saumil A Shah, Benjamin W C Sim, Steven T H Yun, Neeranjali S Jain, Yashar Kalani, Ian C Francis
Aberrant regeneration of the third nerve occurs as a result of synkinetic 'miswiring' of the third nerve following its injury, such as in third cranial nerve palsy due to tumor, trauma, or aneurysm. The case presented is an elderly woman with new vertical diplopia, which led to a diagnosis of a third cranial nerve palsy, thought to be caused by a 5 mm blister aneurysm of the posterior communicating artery. However, neuro-ophthalmological evaluation diagnosed aberrant regeneration of the third nerve, with the cause of her new vertical diplopia being an ipsilateral fourth nerve palsy...
June 12, 2017: Curēus
https://www.readbyqxmd.com/read/28666912/outcome-after-subarachnoid-hemorrhage-from-blood-blister-like-aneurysm-rupture-depends-on-age-and-aneurysm-morphology
#7
Juergen Konczalla, Florian Gessler, Markus Bruder, Joachim Berkefeld, Gerhard Marquardt, Volker Seifert
BACKGROUND: Blood blister-like aneurysms (BBLA) are rare, challenging to treat, and prone to rerupture. We analyzed our results in relationship to type of BBLA and other prognostic factors. METHODS: Data on patient and aneurysm characteristics, clinical course, and treatment results, including data from patient records and review of imaging findings, were collected prospectively and analyzed retrospectively. RESULTS: There were 27 patients (mean age 56 years) with subarachnoid hemorrhage from BBLA...
September 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28619499/results-of-early-high-flow-bypass-and-trapping-for-ruptured-blood-blister-like-aneurysms-of-the-internal-carotid-artery
#8
Yuichiro Kikkawa, Toshiki Ikeda, Ririko Takeda, Hiroyuki Nakajima, Takeshi Ogura, Hidetoshi Ooigawa, Hiroki Kurita
OBJECTIVE: The aim of this study is to clarify the efficacy and safety of early surgery using trapping of the affected internal carotid artery (ICA) and high-flow bypass between the second portion of the middle cerebral artery and cervical external carotid artery with radial artery graft for ruptured blood blister-like aneurysms (BBAs) arising from the anterior wall of the ICA. METHODS: Medical charts of 16 consecutive patients (7 men and 9 women; mean, 59 years) with subarachnoid hemorrhage (World Federation of Neurosurgical Societies grade I, n = 2; grade II, n = 5; grade III, n = 2; grade IV, n = 4; grade V, n = 3) caused by ruptured BBA surgically treated between July 2010 and October 2015 were retrospectively reviewed...
September 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28612579/-endovascular-treatment-of-blood-blister-like-aneurysms-in-internal-carotid-artery
#9
Shou-Wei Xiang, Ding Xu, Chao-Hua Wang, Li-Gang Hu, Chang-Wei Zhang, Xiao-Dong Xie
OBJECTIVES: To study the feasibility and effectiveness of endovascular treatment to blood blister-like aneurysms (BBA) in internal carotid artery. METHODS: Retrospective analyzed the clinical features, outcomes, and complications of 20 cases of BBA treated with endovascular intervention techniques from 2013-2015 in our center. RESULTS: The patients were treated with covered stent, internal carotid artery balloon occlusion, and stents assisted coiling, respectively...
January 2017: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/28565992/pipeline-flow-diversion-of-ruptured-blister-aneurysms-of-the-supraclinoid-carotid-artery-using-a-single-device-strategy
#10
Robert W Ryan, Amir S Khan, Rebecca Barco, Armen Choulakian
OBJECTIVE Ruptured blister aneurysms remain challenging lesions for treatment due to their broad, shallow anatomy and thin, fragile wall. Historical challenges with both open microsurgical approaches and intrasaccular endovascular approaches have led to increased use of flow diversion for management of these aneurysms. However, the optimum paradigm, including timing of treatment, use of dual antiplatelet therapy, and number of flow-diverter devices to use remains unknown. The authors describe their experience with ruptured blister aneurysms treated with flow diversion at their institution, and discuss rates of rebleeding and number of devices used...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28565977/endovascular-treatment-of-blister-aneurysms
#11
Geoffrey W Peitz, Christopher A Sy, Ramesh Grandhi
Blister aneurysms are rare cerebrovascular lesions for which the treatment methods are reviewed here, with a focus on endovascular options. The reported pathogenesis of blister aneurysms varies, and hemodynamic stress, arterial dissection, and arteriosclerotic ulceration have all been described. There is consensus on the excessive fragility of blister aneurysms and their parent vessels, which makes clipping technically difficult. Open surgical treatment is associated with high rates of complications, morbidity, and mortality; endovascular treatment is a promising alternative...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28553172/current-status-of-the-treatment-of-blood-blister-like-aneurysms-of-the-supraclinoid-internal-carotid-artery-a-review
#12
REVIEW
Tiefeng Ji, Yunbao Guo, Xiuying Huang, Baofeng Xu, Kan Xu, Jinlu Yu
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...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/28531340/in-reply-rerupture-of-a-blister-aneurysm-after-treatment-with-a-single-flow-diverting-stent
#13
Marcus D Mazur, Philipp Taussky, Joel D MacDonald, Min S Park
No abstract text is available yet for this article.
September 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28499020/letter-rerupture-of-a-blister-aneurysm-after-treatment-with-a-single-flow-diverting-stent
#14
Leonardo B C Brasiliense, Christina M Walter, Mauricio J Avila, Travis M Dumont
No abstract text is available yet for this article.
September 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28461281/interrater-agreement-in-the-radiologic-characterization-of-ruptured-intracranial-aneurysms-based-on-computed-tomography-angiography
#15
Nicolai Maldaner, Martin N Stienen, Philippe Bijlenga, Davide Croci, Daniel W Zumofen, Donato Dalonzo, Serge Marbacher, Rodolfo Maduri, Roy Thomas Daniel, Carlo Serra, Giuseppe Esposito, Marian Christoph Neidert, Oliver Bozinov, Luca Regli, Jan-Karl Burkhardt
OBJECTIVE: To determine interrater agreement in the initial radiologic characterization of ruptured intracranial aneurysms based on computed tomography angiography (CTA) with special emphasis on the rater's level of experience. METHODS: One junior and one senior rater of 5 high-volume neurovascular tertiary centers evaluated anonymized CTA images of 30 consecutive patients with aneurysmal subarachnoid hemorrhage. Each rater described location, side, size, and morphology in a standardized manner...
July 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28387623/flow-diverter-devices-in-ruptured-intracranial-aneurysms-a-single-center-experience
#16
Emilio Lozupone, Mariangela Piano, Luca Valvassori, Luca Quilici, Guglielmo Pero, Emiliano Visconti, Edoardo Boccardi
OBJECTIVE In this single-center series, the authors retrospectively evaluated the effectiveness, safety, and midterm follow-up results of ruptured aneurysms treated by implantation of a flow diverter device (FDD). METHODS The records of 17 patients (12 females, 5 males, average World Federation of Neurosurgical Societies score = 2.9) who presented with subarachnoid hemorrhage (SAH) due to the rupture of an intracranial aneurysm treated with an FDD were retrospectively reviewed. Of 17 ruptured aneurysms, 8 were blood blister-like aneurysms and the remaining 9 were dissecting aneurysms...
April 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28359923/overlapped-stenting-combined-with-coiling-for-blood-blister-like-aneurysms-comparison-of-low-profile-visualized-intraluminal-support-lvis-stent-and-non-lvis-stent
#17
Deyuan Zhu, Yibin Fang, Pengfei Yang, Ping Zhang, Lei Chen, Yi Xu, Bo Hong, Qinghai Huang, Jian-Min Liu
OBJECTIVE: To evaluate the safety and efficacy of overlapped stenting for blood blister-like aneurysms (BBAs) and to compare the outcomes between Low-profile Visualized Intraluminal Support (LVIS) and non-LVIS stents. METHODS: A retrospective review of the aneurysm database identified 37 patients with intracranial carotid artery BBAs treated by overlapped stenting in our institution from June 2013 to June 2016. The clinical characteristics and angiographic results were reviewed...
August 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28320922/microstructure-of-internal-carotid-blood-blister-aneurysms-under-scanning-electron-microscope
#18
Lu Ma
No abstract text is available yet for this article.
March 21, 2017: Neurology
https://www.readbyqxmd.com/read/28316868/a-case-of-ruptured-blood-blister-like-aneurysm-treated-with-pipeline-embolization-device-clinical-significance-of-fetal-type-posterior-communicating-artery
#19
Ki-Su Park, Dong-Hun Kang, Won-Soo Son, Jaechan Park, Young-Sun Kim, Byung Moon Kim
Blood-blister like aneurysms (BBAs) are challenging lesions because of their wide fragile neck. Flow-diverting stents (FDSs), such as the Pipeline Embolization Device (PED), have been applied to treat BBAs less amenable to more established techniques of treatment. However, the use of FDSs, including the PED, in acute subarachnoid hemorrhage (SAH) still remains controversial. We report a case of aneurysm regrowth following PED application for a ruptured BBA that overlapped the origin of the dominant posterior communicating artery (PCoA), which was successfully treated after coil trapping of the origin of the fetal-type PCoA...
March 2017: Neurointervention
https://www.readbyqxmd.com/read/28298031/analysis-of-saccular-aneurysms-in-the-barrow-ruptured-aneurysm-trial
#20
Robert F Spetzler, Joseph M Zabramski, Cameron G McDougall, Felipe C Albuquerque, Nancy K Hills, Robert C Wallace, Peter Nakaji
OBJECTIVE The Barrow Ruptured Aneurysm Trial (BRAT) is a prospective, randomized trial in which treatment with clipping was compared to treatment with coil embolization. Patients were randomized to treatment on presentation with any nontraumatic subarachnoid hemorrhage (SAH). Because all other randomized trials comparing these 2 types of treatments have been limited to saccular aneurysms, the authors analyzed the current BRAT data for this subgroup of lesions. METHODS The primary BRAT analysis included all sources of SAH: nonaneurysmal lesions; saccular, blister, fusiform, and dissecting aneurysms; and SAHs from an aneurysm associated with either an arteriovenous malformation or a fistula...
February 24, 2017: Journal of Neurosurgery
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