The clinical treatment of blood blister-like aneurysms of internal carotid artery

Abstract

Objective To study the treatment options and prognosis of blood blister-like aneurysms of internal carotid artery. Methods Clinical Data of 15 people with 16 blood blister-1ike aneurysms confirmed by DSA who were admitted to Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2014 to January 2016 were retrospectively studied. In this series, craniotomy was performed in 2 cases (including 1 aneurysm wrapping and 1 clipping) and stent-assisted coil embolization was applied in the other 15 cases. The outcomes of patients undergoing endovascular treatment were assessed based on the modified Rankin Scale (mRS) 3 months post discharge. The mean follow-up period was 11 months and ranged from 3 to 22 months. Results The patient receiving aneurysm wrapping achieved symptomatic improvement and was lost to follow-up after discharge. Postoperative rebleeding occurred in the patient undergoing clipping and resulted in death. Complete embolization was observed in all 13 patients who underwent endovascular treatment. Among the 13 cases, 1 patient died because of postoperative rebleeding and 1 patient developed recurrence at the neck of aneurysm and received a second operation of stent-assisted coil embolization. The mRS assessment for 12 patients at 3 months post discharge indicated 0 in 5 cases, 1 in 6 cases and 4 in 1 case. Conclusion Stent-assisted coil embolization for blood blister-like aneurysms of the internal carotid artery could lead to overall satisfactory outcomes with good safety. Key words: Intracranial aneurysm; Carotid artery, internal; Endovascular procedure; Blood blister-like aneurysm; Craniotomy