Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Department of Interventional Medicine, Beijing Chaoyang Integrative Medicine Emergency Medical Center, Beijing, China.
Neurosurg Rev. 2022 Apr;45(2):1513-1519. doi: 10.1007/s10143-021-01666-3. Epub 2021 Oct 18.
The optimal treatment for blood blister-like aneurysm (BBA) has not yet been determined, and BBA has a high recurrence rate after stent-assisted embolization. The purpose of the present study was to evaluate the safety and feasibility of patients with BBA rupture in the acute phase or patients with BBA who have recurrence after stent-assisted coil embolization. Eight patients (8 women, mean age 50.3 ± 3.7 years) who presented with ruptured BBA or recurrence BBA that had been treated by stent-assisted embolization (5 patients after primary treatment of stent-assisted embolization) were retrospectively reviewed. Clinical follow-up was performed at 1 year after endovascular treatment. All patients were successfully treated with the WCS, and immediate postoperative angiography showed that the aneurysms were completely isolated. The ophthalmic artery was covered by WCS in one patient; however, this patient did not show any clinical visual field or vision symptoms. Procedure-related complications such as aneurysm rupture, vasospasm, acute thrombosis, or thromboembolism did not occur in any case. All patients were followed up for 1 year after endovascular treatment, and they were in good condition without recurrence. One patient developed delayed bleeding at the right temporal lobe. All patients had good clinical prognosis (modified Rankin Scale score ≤ 2). WCS implantation may be a safe and feasible strategy for patients with BBA rupture in the acute phase and patients with BBA who have recurrence after stent-assisted coil embolization and is a promising option worth exploring.
对于血泡样动脉瘤（BBA）的最佳治疗方法尚未确定，并且支架辅助栓塞后 BBA 的复发率较高。本研究旨在评估急性破裂 BBA 或支架辅助线圈栓塞后复发的 BBA 患者的安全性和可行性。回顾性分析了 8 例（8 例女性，平均年龄 50.3±3.7 岁）破裂的 BBA 或支架辅助栓塞后复发的 BBA 患者（5 例为支架辅助栓塞的初次治疗后）。血管内治疗后 1 年进行临床随访。所有患者均成功接受 WCS 治疗，术后即刻血管造影显示动脉瘤完全隔离。1 例患者 WCS 覆盖了眼动脉，但该患者未出现任何临床视野或视力症状。在任何情况下均未发生与手术相关的并发症，如动脉瘤破裂、血管痉挛、急性血栓形成或血栓栓塞。血管内治疗后所有患者均随访 1 年，均无复发，1 例患者右颞叶迟发性出血。所有患者的临床预后良好（改良 Rankin 量表评分≤2）。WCS 植入可能是急性破裂 BBA 患者和支架辅助线圈栓塞后复发的 BBA 患者的一种安全可行的治疗策略，是一种值得探索的有前途的选择。
