Zhang j, yu m, lv x.Endovascular treatment of blood blister-like aneurysms of internal carotid artery: stent-assisted coiling and p ipeline flow diversion.Journal of clinical neuroscience, 90 (2021) 8-13.Https://doi.Org/10.1016/j.Jocn.2021.04.040 medtronic review of the literature article found described retrospective study of 27 patients who underwent endovascular treatment with stent-assisted coiling or pipeline flow diversion to treat subarachnoid hemorrhage (sah) due to rupture of internal carotid artery blood blister-like aneurysms from july 2016 through july 2020.A proximal stenosis caused by angiopathology adjacent to aneurysms were found on internal carotid artery angiograms in all 27 cases.The angiopathology combining with the aneurysms implement that acute dissection of the supraclinoid segment of the internal carotid artery indicated the pathogenesis of blood blister-like aneurysm formation. all aneurysms were treated successfully with alleviation of the adjacent angiopathology after stenting on angiograms.During 1 to 12 months (mean 3.5 months) angiographic followup, complete aneurysm obliteration without adjacent stenosis were found in 25(92.6%) patients.The enterprise stent patient experienced postoperative rebleeding at one week hospital day and the aneurysm was retreated with coils.One lvis patient showed aneurysm recanalization at 3 months follow-up and retreated with coils and another lvis stent.The recurrent rate was 7.4%(2/27) in our patients.There was no recurrent bbla in flow diversion patients.During 1¿12 months (mean 3.5 months) clinical follow-up, favorable clinical mrs 0 and 1 was observed in 23(85.2%) patients, mrs 2 in 3(11.1%) patients and 1(3.7%) death caused by coexisting giant brain arteriovenous malformation rupture.One patient presented with non-occult hydrostatic hydrocephalus.No patient developed clinically significant large vessel vasospasm.Continuous cerebrospinal fluid diversion was performed in the 1 patient presenting with hydrostatic hydrocephalus.
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