Int J Med Sci 2017; 14(4):390-402. doi:10.7150/ijms.17979 This issue Cite

Review

Current status of the treatment of blood blister-like aneurysms of the supraclinoid internal carotid artery: A review

Tiefeng Ji1*, Yunbao Guo2*, Xiuying Huang3, Baofeng Xu2, Kan Xu2, Jinlu Yu2✉

1. Department of Radiology, The First Hospital of Jilin University, Changchun, 130021, P.R. China;
2. Department of Neurosurgery, The First Hospital of Jilin University, Changchun, 130021, P.R. China;
3. Department of Operation, The First Hospital of Jilin University, Changchun, 130021, P.R. China.
*These authors contributed equally to this work.

Citation:
Ji T, Guo Y, Huang X, Xu B, Xu K, Yu J. Current status of the treatment of blood blister-like aneurysms of the supraclinoid internal carotid artery: A review. Int J Med Sci 2017; 14(4):390-402. doi:10.7150/ijms.17979. https://www.medsci.org/v14p0390.htm
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Abstract

Currently, the treatment of blood blister-like aneurysms (BBAs) of the supraclinoid internal carotid artery (ICA) is challenging and utilizes many therapeutic methods, including direct clipping and suturing, clipping after wrapping, clipping after suturing, coil embolization, stent-assisted coil embolization, multiple overlapping stents, flow-diverting stents, covered stents, and trapping with or without bypass. In these therapeutic approaches, the optimal treatment method for BBAs has not yet been defined based on the current understanding of BBAs of the supraclinoid ICA. Therefore, in this study, we aimed to review the literature from PubMed to discuss and analyze the pros and cons of the above approaches while adding our own viewpoints to the discussion. Among the surgical methods, direct clipping was the easiest method if the compensation of the collateral circulation of the intracranial distal ICA was sufficient or direct clipping did not induce stenosis in the parent artery. In addition, the clipping after wrapping technique should be chosen as the optimal surgical modality to prevent rebleeding from these lesions. Among the endovascular methods, multiple overlapping stents (≥3) with coils may be a feasible alternative for the treatment of ruptured BBAs. In addition, flow-diverting stents appear to have a higher rate of complete occlusion and a lower rate of retreatment and are a promising treatment method. Finally, when all treatments failed or the compensation of the collateral circulation of the intracranial distal ICA was insufficient, the extracranial-intracranial (EC-IC) arterial bypass associated with surgical or endovascular trapping, a complex and highly dangerous method, was used as the treatment of last resort.

Keywords: blood blister-like aneurysm, internal carotid artery, supraclinoid segment, treatment, review.


Citation styles

APA
Ji, T., Guo, Y., Huang, X., Xu, B., Xu, K., Yu, J. (2017). Current status of the treatment of blood blister-like aneurysms of the supraclinoid internal carotid artery: A review. International Journal of Medical Sciences, 14(4), 390-402. https://doi.org/10.7150/ijms.17979.

ACS
Ji, T.; Guo, Y.; Huang, X.; Xu, B.; Xu, K.; Yu, J. Current status of the treatment of blood blister-like aneurysms of the supraclinoid internal carotid artery: A review. Int. J. Med. Sci. 2017, 14 (4), 390-402. DOI: 10.7150/ijms.17979.

NLM
Ji T, Guo Y, Huang X, Xu B, Xu K, Yu J. Current status of the treatment of blood blister-like aneurysms of the supraclinoid internal carotid artery: A review. Int J Med Sci 2017; 14(4):390-402. doi:10.7150/ijms.17979. https://www.medsci.org/v14p0390.htm

CSE
Ji T, Guo Y, Huang X, Xu B, Xu K, Yu J. 2017. Current status of the treatment of blood blister-like aneurysms of the supraclinoid internal carotid artery: A review. Int J Med Sci. 14(4):390-402.

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