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Blister aneurysm

Themistoklis I Papasilekas, Konstantinos M Themistoklis, Alexandros A Andreou
Blister aneurysms are rare lesions characterized by a bleb-like appearance in combination with prominent fragility. They mainly affect the supraclinoid internal carotid artery and they are often thought of as dissecting or even false lesions. Treatment of such lesions has been a matter of debate during the past few years with authors competing, in an ever changing field, for best results. Both surgical and endovascular modalities have been tried, with every technique having though its own limitations and pitfalls...
March 7, 2018: Clinical Neurology and Neurosurgery
G Simonte, G Isernia, B Fiorucci, E Paciaroni, E Cieri, A Rebonato, M Lenti
During implantation of an Ovation endograft for abdominal aortic aneurysm correction a patient experienced anaphylactic reaction following polymer leakage outside the device circuit. Procedure was completed after hemodynamic stabilization. Since postoperative day ll, patient complained for loss of legs strength. Medullar injury was excluded by electromyography test and the clinical signs attributed to muscular necrosis and peripheral nerve involvement following arterial embolization. Furthermore, immediately after surgery, a wide erythematous area appeared in the lumbar region...
March 5, 2018: Annals of Vascular Surgery
Vijay Agarwal, Daniel L Barrow
No abstract text is available yet for this article.
March 3, 2018: Operative Neurosurgery (Hagerstown, Md.)
Rajsrinivas Parthasarathy, Vipul Gupta, Aditya Gupta
OBJECTIVES: Blister like aneurysm (BLA) is extremely challenging to treat; endoluminal reconstruction has emerged as the most promising treatment method. When to treat after the ictus, the timing of administration of antiplatelet and causal relationship between platelet function testing results and thromboembolism is unclear. We theorized that Prasugrel with a lower incidence of resistance may be a safe suitable alternative to clopidogrel in patients treated with a flow diverter. METHODS: Prospectively collected data from consecutive patients treated for a ruptured blister with a flow diverter was reviewed...
March 6, 2018: British Journal of Radiology
Maxim Mokin, Angel Chinea, Christopher T Primiani, Zeguang Ren, Peter Kan, Visish M Srinivasan, Ricardo Hanel, Pedro Aguilar-Salinas, Aquilla S Turk, Raymond D Turner, M Imran Chaudry, Andrew J Ringer, Babu G Welch, Vitor Mendes Pereira, Leonardo Renieri, Mariangela Piano, Lucas Elijovich, Adam S Arthur, Ahmed Cheema, Demetrius Klee Lopes, Ahmed Saied, Blaise W Baxter, Harris Hawk, Ajit S Puri, Ajay K Wakhloo, Hussain Shallwani, Elad I Levy, Adnan H Siddiqui, Guilherme Dabus, Italo Linfante
BACKGROUND: Blood blister aneurysms (BBA) are a rare subset of intracranial aneurysms that represent a therapeutic challenge from both a surgical and endovascular perspective. OBJECTIVE: To report multicenter experience with flow diversion exclusively for BBA, located at non-branching segments along the anteromedial wall of the supraclinoidal internal carotid artery (ICA). METHODS: Consecutive cases of BBA located at non-branching segments along the anteromedial wall of the supraclinoidal ICA treated with flow diversion were included in the final analysis...
February 24, 2018: Journal of Neurointerventional Surgery
Xudong Hao, Guilin Li, Jian Ren, Jingwei Li, Chuan He, Hong-Qi Zhang
OBJECTIVE: Blood blister-like aneurysms (BBAs) in the dorsal segment of the internal carotid artery (ICA) are fragile and difficult to treat, and the optimal treatment for BBAs is still controversial. We report clinical and angiographic results with procedural details for the treatment of BBA by using the endovascular patch embolization method. METHODS: We retrospectively reviewed patients who presented with subarachnoid hemorrhage(SAH) caused by ICA-BBAs and were treated with the endovascular patch embolization method in our center from October 2011 to March 2015...
January 8, 2018: World Neurosurgery
Yuxiang Zhang, Yupeng Zhang, Fei Liang, Chuhan Jiang
The use of Willis covered stent (WCS) for intracranial aneurysms has increased based on the promising results of previous studies about its safety and effectiveness. With the accumulation of cases, reports about peri-procedural complications are emerging. In our department, 25 patients were treated with WCS during December 2015 to March 2017. We here reported an unexpected technical complication occurred in the treatment with the WCS for a blood blister-like aneurysm (BBA). During the procedure, the distal end of the stents detached from the dilating balloon partially or as a whole...
2017: Frontiers in Neurology
Paolo Machi, Rafik Ouared, Olivier Brina, Pierre Bouillot, Hasan Yilmaz, Maria I Vargas, Renato Gondar, Philippe Bijlenga, Karl O Lovblad, Zsolt Kulcsár
BACKGROUND AND PURPOSE: Hemodynamics play a driving role in the life cycle of brain aneurysms from initiation through growth until eventual rupture. The specific factors behind aneurysm growth, especially in small aneurysms, are not well elucidated. The goal of this study was to differentiate focal versus general growth and to analyze the hemodynamic microenvironment at the sites of enlargement in small cerebral aneurysms. MATERIALS AND METHODS: Small aneurysms showing growth during follow-up were identified from our prospective aneurysm database...
December 5, 2017: Clinical Neuroradiology
Dale Ding, Robert M Starke, Ayton Hope, Stefan Brew
Internal carotid artery (ICA) blister aneurysms are rare and challenging to successfully treat, using contemporary surgical or endovascular approaches, without partial or complete compromise of the parent vessel. We describe the use of a resheathable flow diverter, the Pipeline Flex Embolization Device (PFED) to perform stent-assisted coiling of a ruptured supraclinoid ICA blister aneurysm in a 56-year-old female who presented with a high-grade subarachnoid hemorrhage (SAH). The first PFED was deployed across the aneurysm neck to jail a microcatheter within the aneurysm dome, and then, two small coils were delivered into the aneurysm...
October 2017: Journal of Neurosciences in Rural Practice
Ding Xu, Changwei Zhang, Ting Wang, Chaohua Wang, David F Kallmes, Giuseppe Lanzino, Chao You, Xiaodong Xie
BACKGROUND: Supraclinoid blister aneurysms (BAs) of the internal carotid artery are uncommon and deadly, and appropriate treatment is controversial. Endovascular reconstruction may allow treatment through aneurysm isolation. We report a single-institution experience in the use of Enterprise stent-assisted coiling (ESAC) for treating BAs to appraise the safety and efficacy of this technique. METHODS: Patients treated with ESAC for a BA at our institution between 2013 and 2016 were retrospectively included in this study...
February 2018: World Neurosurgery
Ding Xu, Xiaodong Xie, Chao You
A male with detected subarachnoid hemorrhage was admitted to our center. During the first angiography, a pulsatile blister aneurysm was revealed and the aneurysm was also noticeably enlarged during the surveillance angiography. The patient accepted balloon-assisted clipping successfully. Blister aneurysms are at a high risk of rupture, high risk of regrowth, and need for multimodal management.
February 2018: World Neurosurgery
Tae Joon Park, Ki Hong Kim, Jae Hoon Cho
Objective: Blood blister-like aneurysm (BBA) is a kind of dorsal wall aneurysm and it is small, sessile, fragile and hazardous because of its high mortality and morbidity. Many challenges tried to establish the management or strategy. But so far, there is no optimal treatment of choice for the BBA. In this article, 17 cases of the ruptured BBA in one institute were analyzed retrospectively. The operative options were correlated with surgical and clinical outcomes. Materials and Methods: During 14 years between October, 2002 and October, 2016, 23 patients were treated for subarachnoid hemorrhage with ruptured dorsal wall aneurysms...
September 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
Yanming Ren, Lunxin Liu, Hong Sun, Yi Liu, Hao Li, Lu Ma, Chang-Wei Zhang, Xiao-Dong Xie, Min He, Chao You, Jin Li
BACKGROUND: Blood-blister aneurysms (BBAs) of the internal carotid artery (ICA) are challenging lesions with high morbidity and mortality. Both surgical and endovascular approaches have been used to treat BBAs; however, little is known about their safety and efficacy. OBJECTIVE: To review our experience with the treatment of BBAs and explore the optimal treatment strategy. METHODS: A total of 83 patients with BBAs were reviewed retrospectively...
January 2018: World Neurosurgery
Russell Cerejo, Mark Bain, Seby John, Julian Hardman, Nina Moore, M Shazam Hussain, Gabor Toth
PURPOSE: Blood blister-like aneurysms (BBA) are small, friable, broad-based aneurysms that represent high risk for rerupture. Treatment of BBA is challenging, and may include surgical wrapping, clipping, multiple overlapping stents, and/or coiling. Flow diversion is a rapidly evolving treatment strategy for intracranial aneurysms, but the evidence for its use in cases of BBA is scarce. METHODS: A retrospective review of flow-diverter-treated, ruptured BBA cases at our tertiary care institution was undertaken...
December 2017: Neuroradiology
James West, Jasmeet Singh, Stacey Q Wolfe, Kyle M Fargen
A 33-year-old man presented with aneurysmal subarachnoid hemorrhage from a ruptured, blister-type sidewall internal carotid artery (ICA) aneurysm. Balloon-assisted coiling was performed with residual neck. He subsequently developed severe vasospasm requiring intra-arterial therapies on multiple occasions, during which it was noted that despite widespread vasospasm, a focal segment of the ICA at the site of the aneurysm showed no significant spasm, suggesting underlying vessel abnormality. He was discharged without deficit and scheduled for flow diversion given concern over this potentially pathologic segment of vessel...
October 13, 2017: BMJ Case Reports
Rami O Almefty, Robert F Spetzler
No abstract text is available yet for this article.
September 22, 2017: Operative Neurosurgery (Hagerstown, Md.)
Fenghua Chen, Longbo Zhang, Quan Cheng, Zheng Huang, Jun Huang, Junyu Wang
BACKGROUND: Blood blister-like aneurysms (BBAs) are rare but dangerous and challenging to treat. Recurrence and rebleeding are often reported, and many neurosurgeons and interventional radiologists are discouraged by such poor outcomes. Currently, there is no standard method to treat this type of aneurysm. CASE DESCRIPTION: We describe 5 cases of ruptured BBAs in the supraclinoid segment of the internal carotid artery, which were treated successfully using a suturing technique...
January 2018: World Neurosurgery
Yunbao Guo, Jinzhu Zhang, Hao Chen, Kan Xu, Jinlu Yu
BACKGROUND: Internal carotid artery (ICA) reconstruction is still the most effective treatment for a blood blister-like aneurysm (BBA) on the supraclinoid segment of the ICA, and clipping after wrapping has the most precise effects. However, the materials used are most often artificial. This study examined the use of autologous dura to replace the artificial materials used for wrapping after suturing a BBA. CASE DESCRIPTION: A 38-year-old man was hospitalized for subarachnoid hemorrhage...
January 2018: World Neurosurgery
Zheng Liu, Shangming Zhang, Shousen Wang, Qizuan Chen
OBJECTIVE: To present a case series of blood blister-like aneurysms (BBAs) of the internal carotid artery (ICA) and an assessment of diagnosis and treatment options, attempting to identify surgical or endovascular management of BBAs with a low complication rate and a functional outcome. METHODS: A retrospective analysis including diagnosis and treatment options of BBAs of the ICA was performed of patients treated for BBAs at Fuzhou General Hospital from January 2008 to September 2016...
December 2017: World Neurosurgery
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 nonbranching 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 BBAs are often challenging. Some of the BBAs have been reported to look like true saccular aneurysms, 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...
December 2017: World Neurosurgery
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