Acta Neurochirurgica

, Volume 156, Issue 11, pp 2071–2077 | Cite as

How I do it: treatment of blood blister-like aneurysms of the supraclinoid internal carotid artery by extracranial-to-intracranial bypass and trapping

  • Ulaş Cıkla
  • Christopher Baggott
  • Mustafa K. BaşkayaEmail author
How I Do it - Vascular



Blood blister-like aneurysms (BBAs) pose a significant challenge to neurosurgeons and neuro-interventionalists. These fragile broad-based aneurysms have a propensity to rupture with minimal manipulation during surgical or endovascular explorations because, unlike saccular aneurysms, they lack all layers of the arterial wall. Aneurysm trapping with extracranial-intracranial (EC-IC) bypass is a safe and durable treatment for BBAs.


We describe our technique and the guiding principles for surgical bypass and trapping of BBAs of the supraclinoid internal carotid artery (ICA).


Treatment of BBAs of the supraclinoid ICA remains difficult. Aneurysm trapping with EC-IC bypass treats BBAs definitively by eliminating the diseased segment of the ICA. We have found the technique and principles described here to be safe and durable in our hands.


Blood blister-like aneurysm Bypass surgery Surgical technique 



Anterior cerebral artery


Anterior choroidal artery


Blood blister-like aneurysms


Balloon test occlusion




External carotid artery


Internal carotid artery


Indocyanine green videoangiography


Middle cerebral artery


Posterior cerebral artery


Posterior communicating artery


Radial artery


Subarachnoid hemorrhage




Conflict of interest


Supplementary material (413 mb)
ESM 1 (MOV 422902 kb)

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Copyright information

© Springer-Verlag Wien 2014

Authors and Affiliations

  • Ulaş Cıkla
    • 1
  • Christopher Baggott
    • 1
  • Mustafa K. Başkaya
    • 1
    Email author
  1. 1.Department of NeurosurgeryUniversity of Wisconsin-Madison, School of MedicineMadisonUSA

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