Internal carotid artery blood blister-like aneurysms are challenging lesions that arise from the artery trunk at non-branching sites. They have been recognized since 1969 and are distinct from typical saccular aneurysms. Usually, these aneurysms are broad-based, with no clearly identifiable neck and have extremely friable and fragile walls, thus with a great propensity to cause subarachnoid hemorrhage and to rupture during treatment. Apparently, blister-like aneurysms are formed through an acquired defect of the inner layers (tunica intima and media) of the internal carotid artery wall, probably due to hemodynamic stress in the carotid siphon.Several surgical and endovascular techniques have been described for the treatment of these aneurysms, however, there is still no consensus on the best technique or method, exposing how challenging the treatment of internal carotid artery blister-like aneurysms is, for both neurosurgeons and neurointerventionists. In this chapter, we review the main aspects of the pathogenesis, diagnosis, and therapeutics and report our experience in the microsurgical treatment of these formidable lesions.
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Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China. Electronic address:
Article Synopsis
- The study investigates the use of intraoperative neurophysiological monitoring (IONM) during surgeries for blood-blister-like aneurysms (BBA), which are complicated due to high risks of complications and death.
- Researchers monitored patients using somatosensory and transcranial motor evoked potentials (SSEPs/tcMEPs) to assess neurological outcomes, revealing a low sensitivity (37.5%) but high specificity (100%) for detecting ischemic events during surgery.
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Neurosurgery Department, Central Hospital of Dalian University of Technology, Dalian.
Background And Aim: Because of relatively little data for blood blister-like aneurysms (BBAs) treated with flow diverter (FD) devices, existing studies failed to provide comprehensive analysis for the characteristics, management, clinical outcome of the disease. Therefore, we collected and analyzed current evidence aiming to provide quantitatively pooled results for the management, complication, clinical and angiographic outcomes as well as the risk factors of prognosis of BBAs treated with FD devices.
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Division of Vascular and Endovascular Neurosurgery, Department of Neurosurgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
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Department of Neurosurgery, China Medical University Hospital, China Medical University, Taichung City, Taiwan. Electronic address:
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