Combined endovascular/neurosurgical therapy of blister-like distal internal carotid aneurysms

Abstract

Objective: To describe a novel therapeutic strategy for the treatment of "blister-like" aneurysms of the distal internal carotid artery (ICA). Direct surgical treatments of these fragile lesions have been associated with generally poor outcomes. Methods: Two consecutive patients presenting with acute subarachnoid hemorrhage from "blister-like" aneurysms were treated with preliminary balloon occlusion of the ICA, followed by surgical trapping of the ICA beyond the aneurysm. Results: The treatment resulted in complete thrombosis of both aneurysms with no clinical complications. Conclusion: This combined endovascular-neurosurgical approach offers a controlled, safer alternative to primary surgical therapy of "blister-like" aneurysms.