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Vascular Surgery 2019
Journal of Vascular and Endovascular Therapy
ISSN: 2573-4482
Page 50
March 28-29, 2019
Rome, Italy
Vascular Surgery
4
th
Edition of World Congress & Exhibition on
Acute EC-IC bypass for ruptured ICA blood blister-like
aneurysms (BBAs)
Yasushi Ueno
Shinko Memorial Hospital, Japan
Yasushi Ueno, J Vasc Endovasc Therapy 2019, Volume 4
DOI: 10.21767/2573-4482-C1-005
Object:
Internal carotid artery (ICA) blood blister-like
aneurysms (BBAs) have fragile aneurysm walls, poorly
defined necks and located at the supraclinoid ICA with
remarkable tendency of preoperative rebleeding, premature
rupture during surgery and enlargement of aneurysmal
dome in the acute stage, so surgical treatment is extremely
challenging. The authors describe the clinical course of
patients with subarachnoid hemorrhage (SAH) caused by
ruptured BBAs and emphasize the usefulness of parent
artery occlusion (PAO) with or without extracranial-
intracranial (EC-IC) bypass in the acute SAH period.
Methods:
Weanalyzed theclinical recordsof 18consecutive
patients (8 male and 8 female) with a mean age of 56 years
(range 29-88 years) treated between January 2005 and
December 2016.
Results:
All 18 patients presentedwith SAHs corresponding
to World Federation of Neurosurgical Societies Grades
I,II, III, IV, and V in 6, 3, 3, 2 and 4 patient, respectively. All
surgery was performed in the acute stage but in 4 of 18
cases we cannot identified BBAs immediately after onset.
3 of the 18 experienced preoperative rebleeding, and
repeated angiography revealed remarkable enlargement
of the aneurysm. 8 patients underwent PAO with bypass,
6 without bypass and 4 underwent interventional
aneurysmal coil embolization. The outcome was excellent
and postoperative angiography demonstrated complete
obliteration of the BBA in 8 patients, good in 6 and dead in 6.
Intraoperative premature bleeding from the BBAs occurred
in 2 of 9 patients who underwent surgical trapping.
Conclusions: Ruptured BBAs were successfully treatedwith
PAO during the acute SAH period.
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