Journal of Korean Society of Geriatric Neurosurgery 2012;8(1):34-38.
Published online June 30, 2012.
Clinical Analysis of Endovascular Treatment of Blood Blister-like Aneurysms of the Internal Carotid Artery
Keuk-Kyu Park , Si-On Kim
Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
내경동맥에서 혈액 - 수포성 뇌동맥류에 대한 혈관 내 치료 환자의 임상 분석
성균관대학교 의과대학 강북삼성병원 신경외과학교실
Aneurysms at nonbranching sites in the supraclinoid internal carotid artery (ICA), known as blood blister-like aneurysms (BBA) or ICA anterior or dorsal wall aneurysms, are not well understood. Blood blister-like aneurysms carry a high rate of morbidity and mortality. The authors analysis 7 cases of BBA treated with reconstructive endovascular methods.
Consecutive 7 patients of ruptured BBAs (6 female and 1 male; mean age 51 years) were treated at the Kangbuk Samsung Hospital between January 2007 and December 2011. Treatment methods and outcomes were analyzed.
All 7 BBAs were initially treated with stent-assisted coil (SAC) embolization. This was followed by a second stent insertion using the stent-within-stent (SWS) technique in 2, covered stent placement in 2, and SAC embolization alone in 3. All 3 patients who underwent SAC alone had good outcome but regrowth of 1 patient retreated with covered stent. One of 2 patients who received covered stent had excellent outcome but 1 patient expired due to rebleeding during procedure. All 2 patients of SWS had good outcomes and complete resolution.
In the present study, reconstructive endovascular treatment for BBA prevented rebleeding without sacrifice of the ICA. In patients of BBA, the SWS and covered stent techniques can be considered an alternative methods for prevent rebleeding and regrowth.
Key Words: Blood blister-like aneurysmㆍCovered stentㆍStent assisted coil embolizationㆍInternal carotid artery

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