Clinical Aanalysis of ICA Trunk Blood Blister-like Aneurysm

, Jae Kwan Lim1; , Hyung Sik Hwang1; , Seung Myung Moon1, Je Hoon Jeong1; , Seung Hun Sheen1; , Ki Hoon Choi2

Clinical Article

Journal of Korean Society of Geriatric Neurosurgery 2009;5(2):123-130.
Published online December 30, 2009.

Clinical Aanalysis of ICA Trunk Blood Blister-like Aneurysm

Jae Kwan Lim1 , Hyung Sik Hwang1 , Seung Myung Moon1, Je Hoon Jeong1 , Seung Hun Sheen1 , Ki Hoon Choi2

Department of Neurosurgery1, and Emergency2, Hangang Sacred Heart Hospital, College of Medicine,
Hallym University, Seoul, Korea

Abstract

Objective
We aim to investigate the clinical characteristics of blood blister-like aneurysms (BBAs) of the internal carotid artery.
Methods
We retrospectively reviewed 876 patients with aneurysmal subarachnoid hemorrhage at the Hallym Medical Center between January 2001 and January 2009. There were 25 ICA trunk aneurysms, of which 16 were BBA and 9 were saccular aneurysm, including 1 giant aneurysm by intraoperative recording tapes, operative records and angiographies. Saccular aneurysms were excluded on this study. 16 BBA patients received treatments; clipping (11), trapping (2), GDC (2) and wrapping (1) were undertaken.
Results
The average of the Hunt-Hess grade (H-H G) and the Fischer grade (F G) were 3.3 in the BBAs, with 50% of BBAs having had a history of hypertension. Otherwise, ten (62.5%) of the BBAs had intraoperative rupturing. The mean GOS was 2.7 and mortality rate was very high as 43.8%.
Conclusion
The clipping and simple coiling have the dangerous risk of developing high mortality and morbidity with the perioperative rupture for the treatment of blister-type aneurysm. Modified Sundt clip can be a treatment strategy for BBAs.

Key Words: Subarachnoid hemorrhageㆍBlood blister-like aneurysmㆍInternal carotid artery