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Endovascular isolation of intracranial blood blister-like aneurysms with Willis covered stent
  1. Chun Fang1,
  2. Hua-Qiao Tan1,
  3. Hong-Jie Han1,
  4. Hao Feng1,
  5. Ji-Chong Xu1,
  6. Shuo Yan1,
  7. Zhi-Yu Nie2,
  8. Ling-Jing Jin2,
  9. Fei Teng2
  1. 1Department of Interventional Radiology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
  2. 2Department of Neurology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
  1. Correspondence to Dr Fei Teng, Department of Neurology, Shanghai Tongji Hospital, Tongji University School of Medicine, 389, Xincun Road, Shanghai 200065, China; iamtengfei{at}hotmail.com

Abstract

Objective Intracranial blood blister-like aneurysm (BBA) is a rare type of aneurysm that lacks all layers of the arterial wall. These fragile aneurysms have the propensity to rupture with minimal manipulation, which makes them hazardous and difficult to treat. The present study evaluated the safety and feasibility of endovascular treatment of BBAs with the Willis covered stent.

Materials Thirteen patients (7 men and 6 women, age range 28–68 years) who presented with ruptured BBAs and were treated with the Willis covered stent were retrospectively reviewed. Results of the procedures and treatment-related complications were recorded. Angiographic and clinical follow-ups were performed 4–6 months after the procedure.

Results Placement of the covered stent was successful in all patients. Immediate angiography showed complete aneurysm occlusion in 12 patients while one patient showed a mild endoleak. This high rate of aneurysm exclusion ensured the security of postoperative antiplatelet treatment. Occlusion of the ophthalmic artery occurred in two patients and occlusion of the anterior choroidal artery occurred in one patient; however, none of them showed acute or delayed clinical symptoms. Thrombosis, aneurysm rupture, and other complications did not develop in any case. Angiographic follow-up showed complete aneurysm exclusion without aneurysm recurrence in any patients. Only two patients showed asymptomatic mild to moderate in-stent stenosis. All patients had satisfactory clinical outcomes (modified Rankin Scale score ≤1).

Conclusions Willis covered stent implementation may be safe and feasible for BBAs. This strategy might be a promising option for this high-risk type of aneurysm.

  • Aneurysm
  • Angiography
  • Stent
  • Device

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Footnotes

  • CF and H-QT contributed equally.

  • Contributors All authors were included in planning, conducting and reporting the work. Conception and design: CF, H-QT and FT. Operation procedure: CF, H-QT, H-JH, HF, J-CX and SY. Acquisition, analysis and interpretation of the data: CF and FT. Manuscript preparation: FT. Manuscript review and critique: Z-YN, L-JJ, H-QT and CF.

  • Funding This work was supported by the National Natural Science Foundation of China, grant number 81400961.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval This study was approved by the ethics committee of Shanghai Tongji Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement For any questions regarding data sharing please contact the corresponding author.

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