Surgical Strategies and Clinical Results of Site-Specific Treatment Using High-Flow Bypass for Ruptured Blood Blister-Like Anterior Wall Aneurysms of the Internal Carotid Artery

World Neurosurgery
Masanori AiharaYuhei Yoshimoto

Abstract

Surgical treatment of ruptured blood blister-like aneurysms (BBAs) arising from the internal carotid artery (ICA) is challenging. We retrospectively reviewed the results of our surgical strategies tailored for each aneurysm site. All ruptured ICA BBAs treated between 2003 and 2015 were reviewed. Aneurysms on the lateral side of the ICA were classified as type A, on the medial side of C2 as type B, and on the medial side of C1 as type C. The principal strategy was high-flow bypass (HFB) by use of a radial artery graft, with clipping, trapping, or proximal occlusion selected on the basis of aneurysm type. The results of each treatment were examined. This study included 20 patients. There were 11 type A aneurysms (55%), 2 type B (10%), and 7 type C (35%). HFB was used in 13 patients (65%) and low-flow bypass in 4 (20%). Except for 1 case, no other cases of rerupture or recurrence occurred. Severe ischemia due to cerebral vasospasm was confirmed in 4 of 20 patients (20%), 3 of whom had not received HFB. Modified Rankin Scale score was 0-2 in 16 of 20 patients (80%). Inadequate cerebral blood flow is a distinct possibility even with HFB, so parent artery flow should be preserved to protect against ischemia whenever possible. However...Continue Reading

Citations

Apr 23, 2020·Neurosurgical Review·Torstein R Meling, Gildas Patet
Feb 16, 2021·Clinical Neurology and Neurosurgery·Luca RicciardiCarmelo Lucio Sturiale
Jul 17, 2021·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Mohamed NasraHamed Asadi
Jul 6, 2021·World Neurosurgery·Victoria E SanchezJeremiah N Johnson

❮ Previous
Next ❯

Related Concepts

Related Feeds

Aneurysm

Aneurysms are outward distensions or bulges that occurs in a weakened wall of blood vessels. Discover the latest research on aneurysms here.

Carotid Artery Diseases

Carotid artery disease is a group of pathological conditions of the carotid artery. Discover the latest research on carotid artery disease here.