Jong Young Lee MD, Presenter: Nothing to Disclose

Jeong Hwa Seo MD, Abstract Co-Author: Nothing to Disclose

Seung Jin Lee MD, Abstract Co-Author: Nothing to Disclose

Hyun-Seung Kang MD, Abstract Co-Author: Nothing to Disclose

Moon Hee Han MD, Abstract Co-Author: Nothing to Disclose

Blood blister-like aneurysms (BBAs) of the internal carotid artery (ICA) are very rare but carry a high rate of morbidity and mortality. We present our experience in treating BBAs using self-expandable stents.

Eight BBAs in 8 consecutive patients (2 male and 6 female; mean age 51.4 years) were treated using self-expandable stents during the period between October 2008 and March 2011. Angiographic and clinical outcomes were retrospectively evaluated.

 Six of 8 BBAs were initially treated with stent-assisted coil embolization. This was followed by a one or more additional stent insertion using stent-within-a-stent technique in 5. Two of 8 BBAs treated using one or two self-expandable stents without coil embolization. Total occlusion of BBAs was achieved in 6, small neck remnant remained in 1 and residual sac filling in 1. In-stent thrombosis was developed in 5 procedures, and was lysed with intra-arterial (IA) infusion of tirofiban. Vasospasm developed in 5 patients, and IA infusion of nimodipine was performed in all of them. One patient died due to rebleeding. Except one mortality case, all of 7 patients showed excellent clinical outcomes (GOS = 5) at the last follow-up. Aneurysmal regrowth developed in one case, and he underwent additional coil embolization. During 37 months of follow-up period after second-session procedure, it remained stable.

 In the present study, the endovascular treatment using self-expandable stents effectively prevented rebleeding and regrowth of the BBA without sacrifice of the ICA. Because this strategy could preserve ICA, vasospasm could be actively managed, resulting in good clinical outcomes.

 Endovascular treatment using self-expandable stents could be considered a effective and safe treatment option for BBAs.

Lee, J, Seo, J, Lee, S, Kang, H, Han, M, Endovascular Treatment of Blood Blister-like Aneurysms of Internal Carotid Artery Using Self-expandable Stents.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034507.html