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- W4386093061 abstract "Background Blister like aneurysms (BLA) are a rare form of aneurysms contributing to around 0.3 to 1% of all intracranial aneurysms. They are small, broad-based aneurysms usually less than 3 mm in diameter with very thin walls. They are most commonly found along the non-branching points of the supraclinoid portion of the internal carotid artery. It appears as thorn-like protrusions on angiography such as Computed Tomography angiography (CTA) and Digital Subtraction Angiography (DSA) the latter having a higher sensitivity than the former for BLAs albeit more invasive. BLAs may show early aneurysm growth within days to weeks after diagnosis. They have a slight female preponderance and are associated with atherosclerosis although their actual pathophysiology remains elusive. Aim of the Work To compare the degree of occlusion on conventional angiography in BLA patients treated with flow diverters with those treated by microsurgical clipping within one year of intervention. Patients and Methods Most BLAs are diagnosed after an episode of subarachnoid hemorrhage (SAH) and present clinically with a high WFNS score (World Federation of Neurological Surgeons) while the rest of BLAs are diagnosed incidentally on imaging. Due to their unique histology, BLAs are associated with higher rates of rebleed and intraoperative and post-operative rupture. Due to their small size, thin walls and tendency to re-bleed BLA are considered a challenge to both neurosurgeons and neuroradiologists. Results Our search strategy using previously mentioned key wards identified a total of 67 citations. Search was done for studies conducted or published within 2010 to 2020 duration. After removal of duplicate studies, eligibility criteria were applied to the titles of 43 articles with exclusion of non-human population and non-appropriate study design. This yielded 23 studies that underwent full-text analysis, of which 17 did not meet the inclusion criteria of having and lacking of quantitative comparison data. Six studies were included in our systematic review for analysis of population demographics and management outcome with attention to the clinical and radiological outcomes of both microsurgical clipping and flow diversion for treatment of BBAs. Conclusion In our mid-term follow-up study, we saw high occlusion and low retreatment/rerupture rates with good clinical outcomes in the majority of cases. However, dual antiplatelet therapy in the acute ruptured setting can be challenging, and requires special considerations." @default.
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- W4386093061 date "2023-06-01" @default.
- W4386093061 modified "2023-09-25" @default.
- W4386093061 title "Flow Diverters versus Clipping in the Management of Blister Like Intracranial Aneurysms" @default.
- W4386093061 doi "https://doi.org/10.1093/qjmed/hcad069.522" @default.
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