Primary treatment of ruptured blood blister-like aneurysms with stent-assisted coil embolization: report of two cases

Acta Radiol. 2008 Mar;49(2):180-3. doi: 10.1080/02841850701675735.

Abstract

Blood blister-like aneurysms (BBAs) are among the most hazardous cerebrovascular aneurysms to treat; microsurgical treatment of these small, wide-necked, and exceptionally fragile aneurysms place patients at significant risk of morbidity or mortality. We report two cases of ruptured BBAs attempted to be treated for the first time with stent-assisted coil embolization solely and review the current literature on treatment options. Our patients underwent stent-assisted coil embolization of the aneurysms in the acute stage of subarachnoid hemorrhage (SAH). One patient was successfully treated without procedure-related complications. The other patient died after surgical internal carotid artery (ICA) occlusion, carried out after intraoperative rerupture of the aneurysm during the endovascular treatment. In the successful case, 8-month and 19-month follow-up angiograms demonstrated incomplete (>90%) occlusion with residual filling of the aneurysm neck, which did not need additional coil embolization. Even though stent-assisted coil embolization of ruptured BBAs in the acute stage appears to be a technically feasible treatment option, the present stent-related endovascular technology has potentially hazardous drawbacks.

Publication types

  • Case Reports

MeSH terms

  • Aneurysm, Ruptured / complications
  • Aneurysm, Ruptured / diagnosis
  • Aneurysm, Ruptured / therapy*
  • Angiography, Digital Subtraction
  • Brain Ischemia / etiology
  • Carotid Artery Diseases / complications
  • Carotid Artery Diseases / diagnosis
  • Carotid Artery Diseases / therapy*
  • Carotid Artery, Internal / diagnostic imaging
  • Embolization, Therapeutic / methods*
  • Fatal Outcome
  • Female
  • Follow-Up Studies
  • Humans
  • Intracranial Aneurysm / complications
  • Intracranial Aneurysm / diagnosis
  • Intracranial Aneurysm / therapy*
  • Intraoperative Complications
  • Male
  • Middle Aged
  • Rupture, Spontaneous
  • Stents*
  • Stroke / etiology
  • Subarachnoid Hemorrhage / diagnosis
  • Subarachnoid Hemorrhage / etiology
  • Subarachnoid Hemorrhage / therapy*
  • Treatment Outcome