Skip to main content
SpringerLink
Log in

Endovascular internal carotid artery trapping for ruptured blood blister-like aneurysms: long-term results from a single centre

  • Interventional Neuroradiology
  • Published:
Neuroradiology Aims and scope Submit manuscript

Abstract

Introduction

Endovascular internal carotid artery (ICA) trapping was performed to treat ruptured blood blister-like aneurysms (BBAs). The aim of this study was to evaluate the procedural risks and long-term follow-up results.

Methods

The records of 11 consecutive patients with BBAs who underwent endovascular ICA trapping between 2005 and 2010 were reviewed. Clinical outcomes were assessed with modified Rankin Scale (mRS) scores.

Results

Endovascular ICA trapping was performed in 11 patients as either the primary treatment (7 patients) or the secondary treatment (4 patients) after the patient underwent other treatments. Three patients underwent superficial temporal artery (STA)-middle cerebral artery (MCA) bypass when balloon test occlusion (BTO) revealed inadequate collateral circulation. In the primary ICA trapping group (seven patients), six patients had good outcomes (mRS 0 in five, mRS 1 in one), and one patient had a poor outcome (mRS 6: dead). In the secondary ICA trapping group (four patients), two patients had good outcomes (mRS 0), and two patients had poor outcomes (mRS 4, 5). All ten of the surviving patients were clinically stable during the follow-up period (mean 39 months). A radiological follow-up of nine patients (mean 22 months) demonstrated stable occlusion, with the exception of one reopening of the ICA because of coil migration. Perfusion studies of nine patients (mean: 23 months) demonstrated no perfusion decrease.

Conclusion

Endovascular ICA trapping is an effective and durable treatment for BBAs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Abe M, Tabuchi K, Yokoyama H, Uchino A (1998) Blood blisterlike aneurysms of the internal carotid artery. J Neurosurg 89:419–424

    Article  CAS  PubMed  Google Scholar 

  2. Meling TR, Sorteberg A, Bakke SJ, Slettebo H, Hernesniemi J, Sorteberg W (2008) Blood blister-like aneurysms of the internal carotid artery trunk causing subarachnoid hemorrhage: treatment and outcome. J Neurosurg 108:662–671

    Article  PubMed  Google Scholar 

  3. Ogawa A, Suzuki M, Ogasawara K (2000) Aneurysms at nonbranching sites in the surpaclinoid portion of the internal carotid artery: internal carotid artery trunk aneurysms. Neurosurgery 47:578–583, discussion 583–586

    CAS  PubMed  Google Scholar 

  4. Yoshimoto Y, Ochiai C, Nagai M (1996) Cerebral aneurysms unrelated to arterial bifurcations. Acta Neurochir (Wien) 138:958–963, discussion 963–964

    Article  CAS  Google Scholar 

  5. Lee JW, Choi HG, Jung JY, Huh SK, Lee KC (2009) Surgical strategies for ruptured blister-like aneurysms arising from the internal carotid artery: a clinical analysis of 18 consecutive patients. Acta Neurochir (Wien) 151:125–130

    Article  Google Scholar 

  6. Lee BH, Kim BM, Park MS et al (2009) Reconstructive endovascular treatment of ruptured blood blister-like aneurysms of the internal carotid artery. J Neurosurg 110:431–436

    Article  PubMed  Google Scholar 

  7. Park JH, Park IS, Han DH et al (2007) Endovascular treatment of blood blister-like aneurysms of the internal carotid artery. J Neurosurg 106:812–819

    Article  PubMed  Google Scholar 

  8. Ohkuma H, Tsurutani H, Suzuki S (2001) Incidence and significance of early aneurysmal rebleeding before neurosurgical or neurological management. Stroke 32:1176–1180

    Article  CAS  PubMed  Google Scholar 

  9. Fujii Y, Takeuchi S, Sasaki O et al (1996) Ultra-early rebleeding in spontaneous subarachnoid hemorrhage. J Neurosurg 84:35–42

    Article  CAS  PubMed  Google Scholar 

  10. Adud DG, Spelle L, Piotin M et al (2005) Venous phase timing during balloon test occlusion as a criterion for permanent internal carotid artery sacrifice. Am J Neuroradiol 26:2602–2609

    Google Scholar 

  11. Baskaya MK, Ahmed AS, Ates O, Niemann D (2008) Surgical treatment of blood blister-Like aneurysms of the supraclinoid internal carotid artery with extracranial-intracranial bypass and trapping. Neurosurg Focus 24:1–8

    Google Scholar 

  12. Lennihan L, Mayer SA, Fink ME et al (2000) Effect of hypervolemic therapy on cerebral blood flow after subarachnoid hemorrhage: a randomized controlled trial. Stroke 31:383–391

    Article  CAS  PubMed  Google Scholar 

  13. Treggiari MM, Walder B, Suter PM, Romand JA (2003) Systematic review of the prevention of delayed ischemic neurological deficits with hypertension, hypervolemia, and hemodilution therapy following subarachnoid hemorrhage. J Neurosurg 98:978–984

    Article  PubMed  Google Scholar 

  14. Sen J, Belli A, Albon H et al (2003) Triple-H therapy in the management of aneurysmal subarachnoid haemorrhage. Lancet Neurol 2:614–621

    Article  PubMed  Google Scholar 

  15. Klimo P Jr, Kestle JR, MacDonald JD, Schmidt RH (2004) Marked reduction of cerebral vasospasm with lumbar drainage of cerebrospinal fluid after subarachnoid hemorrhage. J Neurosurg 100:215–224

    Article  PubMed  Google Scholar 

  16. Al-Tamimi YZ, Bhargava D, Feltbower RG et al (2012) Lumbar drainage of cerebrospinal fluid after aneurysmal subarachnoid hemorrhage: a prospective, randomized, controlled trial (LUMAS). Stroke 43:677–682

    Article  PubMed  Google Scholar 

  17. Kwon OY, Kim YJ, Kim YJ et al (2008) The utility and benefits of external lumbar CSF drainage after endovascular coiling on aneurysmal subarachnoid hemorrhage. J Korean Neurosurg Soc 43:281–287

    Article  PubMed Central  PubMed  Google Scholar 

  18. Yu-Tse L, Ho-Fai W, Cheng-Chi L et al (2012) Rupture of symptomatic blood blister-like aneurysm of the internal carotid artery: clinical experience and management outcome. Br J Neurosurg 26:378–382

    Article  PubMed  Google Scholar 

  19. Ishikawa T, Nakamura N, Houkin K, Nomura M (1997) Pathological consideration of a “blister-like” aneurysm at the superior wall of the internal carotid artery: case report. Neurosurgery 40:403–406

    Article  CAS  PubMed  Google Scholar 

  20. Charbel FT, Gonzales-Portillo G, Hoffman W, Ostergren LA, Misra M (1999) Distal internal carotid artery pseudoaneurysms: technique and pitfalls of surgical management: two technical case reports. Neurosurgery 45:643–648, discussion 648–649

    Article  CAS  PubMed  Google Scholar 

  21. Kurokawa Y, Wanibuchi M, Ishiguro M, Inaba K (2001) New method for obliterative treatment of an anterior wall aneurysm in the internal carotid artery: encircling silicone sheet clip procedure—technical case report. Neurosurgery 49:469–472

    CAS  PubMed  Google Scholar 

  22. Fang YB, Li Q, Yang PF et al (2013) Treatment of blood blister-like aneurysms of the internal carotid artery with stent-assisted coil embolization. Clin Neurol Neurosurg 115:920–925

    Article  PubMed  Google Scholar 

  23. Ihn YK, Kim SH, Sung JH, Kim TG (2012) The efficacy of endovascular treatment of ruptured blood blister-like aneurysms using stent-assisted coil embolization. Interv Neuroradiol 18:432–441

    CAS  PubMed Central  PubMed  Google Scholar 

  24. Matsubara N, Miyachi S, Tsukamoto N et al (2011) Endovascular coil embolization for saccular-shaped blood blister-like aneurysms of the internal carotid artery. Acta Neurochir (Wien) 153:287–294

    Article  Google Scholar 

  25. Bogousslavsky J, Regli F, Assal G (1986) The syndrome of unilateral tuberothalamic artery territory infarction. Stroke 17:434–441

    Article  CAS  PubMed  Google Scholar 

  26. Schmahmann JD (2003) Vascular syndromes of the thalamus. Stroke 34:2264–2278

    Article  PubMed  Google Scholar 

  27. Gillilan LA (1961) The collateral circulation of the human orbit. Arch Ophthalmol 65:684–694

    Article  Google Scholar 

  28. Mawn LA, Hedges TR 3rd, Rand W, Heggerick PA (1997) Orbital color Doppler imaging in carotid occlusive disease. Arch Ophthalmol 115:492–496

    Article  CAS  PubMed  Google Scholar 

  29. Dehdashti AR, Safran AB, Martin JB, Rüfenacht DA, de Tribolet N (2002) Intraorbital ophthalmic artery aneurysm associated with basilar tip saccular aneurysm. Neuroradiology 44:600–603

    Article  CAS  PubMed  Google Scholar 

  30. Shaibani A, Khawar S, Bendok B, Walker M, Russell EJ, Batjer HH (2004) Temporary balloon occlusion to test adequacy of collateral flow to the retina and tolerance for endovascular aneurysmal coiling. Am J Neuroradiol 25:1384–1386

    PubMed  Google Scholar 

  31. Yamamoto T, Mori K, Yasuhara T et al (2004) Ophthalmic artery blood flow in patients with internal carotid artery occlusion. Br J Ophthalmol 88:505–508

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  32. Mames RN, Snady-McCoy L, Guy J (1991) Central retinal and posterior ciliary artery occlusion after particle embolization of the external carotid artery system. Ophthalmology 98:527–531

    Article  CAS  PubMed  Google Scholar 

  33. Mathis JM, Barr JD, Jungreis CA et al (1995) Temporary test occlusion of the internal carotid artery: experience in 500 Cases. Am J Neuroradiol 16:749–754

    CAS  PubMed  Google Scholar 

  34. Gevers S, Heijtel D, Ferns SP et al (2012) Cerebral perfusion long term after therapeutic occlusion of the internal carotid artery in patients who tolerated angiographic balloon test occlusion. Am J Neuroradiol 33:329–335

    Article  CAS  PubMed  Google Scholar 

  35. Murakami K, Shimizu H, Matsumoto Y, Tominaga T (2009) Acute ischemic complications after therapeutic parent artery occlusion with revascularization for complex internal carotid artery aneurysms. Surg Neurol 71:434–441

    Article  PubMed  Google Scholar 

  36. Kim JY, Jo KW, Kim YW et al (2010) Changes in bypass flow during temporary occlusion of unused branch of superficial temporal artery. J Korean Neursurg Soc 48:105–108

    Article  Google Scholar 

  37. De Gast AN, Sprengers ME, van Rooij WJ et al (2007) Midterm clinical and magnetic resonance imaging follow-up of large and giant carotid artery aneurysms after therapeutic carotid artery occlusion. Neurosurgery 60:1025–1029, discussion 1029-1031

    PubMed  Google Scholar 

  38. Hacein-Bey L, Connolly ES Jr, Duong H et al (1997) Treatment of inoperable carotid aneurysms with endovascular carotid occlusion after extracranial-intracranial bypass surgery. Neurosurgery 41:1225–1231, discussion 1231-1234

    Article  CAS  PubMed  Google Scholar 

  39. Larson JJ, Tew JM Jr, Tomsick TA, van Loveren HR (1995) Treatment of aneurysms of the internal carotid artery by intravascular balloon occlusion: long-term follow-up of 58 patients. Neurosurgery 36:26–30, discussion 30

    CAS  PubMed  Google Scholar 

  40. Roski RA, Spetzler RF, Nulsen FE (1981) Late complications of carotid ligation in the treatment of intracranial aneurysms. J Neurosurg 54:583–587

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by the Dongguk University Research Fund of 2010. The organisation had no role in this study.

Conflict of interest

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Dongguk University Ilsan Hospital, Goyang, South Korea

    Byong-Cheol Kim

  2. Department of Neurosurgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Seongnam, Gyeonggi, 463-707, South Korea

    O-Ki Kwon, Chang Wan Oh, Jae Seung Bang & Gyojun Hwang

  3. Department of Neurosurgery, Inje University Haeundae Paik Hospital, Busan, South Korea

    Sung-Chul Jin

  4. Department of Neurosurgery, Gyeongsang National University Hospital, Gyeongsangnam-do, South Korea

    Hyun Park

Authors
  1. Byong-Cheol Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. O-Ki Kwon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chang Wan Oh
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jae Seung Bang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gyojun Hwang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sung-Chul Jin
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hyun Park
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to O-Ki Kwon.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kim, BC., Kwon, OK., Oh, C.W. et al. Endovascular internal carotid artery trapping for ruptured blood blister-like aneurysms: long-term results from a single centre. Neuroradiology 56, 211–217 (2014). https://doi.org/10.1007/s00234-014-1317-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00234-014-1317-3

Keywords

Search

Navigation