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KMID : 1005420120140020099
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Journal of Cerebrovascular and Endovascular Neurosurgery
2012 Volume.14 No. 2 p.99 ~ p.103
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Salvage Surgical Treatment for Failed Endovascular Procedure of a Blood Blister-Like Aneurysm
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Cho Tack-Geun
Hwang Sung-Nam
Nam Taek-Kyun
Park Seung-Won
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Abstract
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The blood blister-like aneurysm (BBA) of the internal carotid artery (ICA) is a rare but clinically important cause of subarachnoid hemorrhage (SAH), which accounts for 0.5% of incidences of ruptured intracranial aneurysms. BBA is a thin-walled, broad-based aneurysm that lacks an identifiable neck and is one of the most difficult lesions to treat. In this paper, a case is presented of a 57-year-old woman with SAH. Her cerebral angiography demonstrated a small BBA on the dorsal wall of her right ICA. Endovascular treatment that consisted of a stent-within-a-stent was attempted, but the replacement of the second stent failed, and the aneurysm became bigger. Surgery was performed by clipping the BBA with a Sundt slim-line encircling graft clip. The patient completely recovered with no complications. This treatment may be a salvageable option for BBA, especially when endovascular treatment has failed.
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KEYWORD
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Blood-blister like aneurysm, Internal carotid artery, Subarachnoid hemorrhage, Encircling graft clip, Endovascular stent
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