Surgical treatment of blood blister-like aneurysms of the supraclinoid internal carotid artery with extracranial-intracranial bypass and trapping.
Neurosurg Focus
; 24(2): E13, 2008.
Article
en En
| MEDLINE
| ID: mdl-18275289
ABSTRACT
OBJECT Blood blister-like aneurysms (BBAs) arise from the supraclinoid internal carotid artery (ICA) at non-branching sites. These aneurysms are challenging to treat primarily with either surgical clip placement or endovascular therapy. The authors describe a series of 4 patients who presented with high-grade subarachnoid hemorrhage (SAH) due to a BBA, which was treated with an extracranial-intracranial (EC-IC) bypass followed by trapping of the aneurysm. METHODS:
Four patients presented with SAH due to a BBA of the ICA. Three of these patients were treated with an endovascular procedure; following the vasospasm period, definitive treatment with EC-IC bypass followed by trapping of the aneurysmal parent vessel was performed.RESULTS:
Two of the patients who were treated endovascularly suffered rebleeding prior to bypass and trapping. Three of the 4 patients had a good outcome (modified Rankin Scale Score 1 or 2), and 1 patient who suffered 2 episodes of rebleeding died.CONCLUSIONS:
Treatment of BBAs of the ICA remains difficult, particularly in the setting of high-grade SAH. Patients with this challenging condition often require multiple procedures and have a high incidence of rebleeding. Definitive treatment of these aneurysms consists of EC-IC bypass and surgical or endovascular trapping.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Enfermedades de las Arterias Carótidas
/
Arteria Carótida Interna
/
Revascularización Cerebral
/
Aneurisma
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
Límite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Neurosurg Focus
Asunto de la revista:
NEUROCIRURGIA
Año:
2008
Tipo del documento:
Article
País de afiliación:
Estados Unidos