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How I do it: treatment of blood blister-like aneurysms of the supraclinoid internal carotid artery by extracranial-to-intracranial bypass and trapping

  • How I Do it - Vascular
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Abstract

Background

Blood blister-like aneurysms (BBAs) pose a significant challenge to neurosurgeons and neuro-interventionalists. These fragile broad-based aneurysms have a propensity to rupture with minimal manipulation during surgical or endovascular explorations because, unlike saccular aneurysms, they lack all layers of the arterial wall. Aneurysm trapping with extracranial-intracranial (EC-IC) bypass is a safe and durable treatment for BBAs.

Methods

We describe our technique and the guiding principles for surgical bypass and trapping of BBAs of the supraclinoid internal carotid artery (ICA).

Conclusions

Treatment of BBAs of the supraclinoid ICA remains difficult. Aneurysm trapping with EC-IC bypass treats BBAs definitively by eliminating the diseased segment of the ICA. We have found the technique and principles described here to be safe and durable in our hands.

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Abbreviations

ACA:

Anterior cerebral artery

AchoA:

Anterior choroidal artery

BBAs:

Blood blister-like aneurysms

BTO:

Balloon test occlusion

EEG:

Electroencephalography

ECA:

External carotid artery

ICA:

Internal carotid artery

ICG-VA:

Indocyanine green videoangiography

MCA:

Middle cerebral artery

PCA:

Posterior cerebral artery

PcomA:

Posterior communicating artery

RA:

Radial artery

SAH:

Subarachnoid hemorrhage

SCM:

Sternocleidomastoid

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Conflict of interest

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Authors and Affiliations

  1. Department of Neurosurgery, University of Wisconsin-Madison, School of Medicine, CSC, K4/822, 600 Highland Avenue, Madison, WI, 53792, USA

    Ulaş Cıkla, Christopher Baggott & Mustafa K. Başkaya

Authors
  1. Ulaş Cıkla
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  2. Christopher Baggott
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  3. Mustafa K. Başkaya
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Corresponding author

Correspondence to Mustafa K. Başkaya.

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Cıkla, U., Baggott, C. & Başkaya, M.K. How I do it: treatment of blood blister-like aneurysms of the supraclinoid internal carotid artery by extracranial-to-intracranial bypass and trapping. Acta Neurochir 156, 2071–2077 (2014). https://doi.org/10.1007/s00701-014-2212-8

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  • DOI: https://doi.org/10.1007/s00701-014-2212-8

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