Türk Nöroşirürji Dergisi 2018 , Vol 28 , Num 1
Endovascular Treatment for Blister and Dissecting Aneurysms
Ali İhsan ÖKTEN1,Yurdal GEZERCAN1,Vedat AÇIK1
1Adana Numune Eğitim ve Araştırma Hastanesi, Nöroşirürji Kliniği, Adana, Türkiye Blister aneurysms are half-dome aneurysms that develop in the non-branching regions of the internal carotid artery (ICA). They can be seen in the anterior and posterior circulations but a supraclinoid ICA is the most common form. They account for 0.3-1.7% of ICA aneurysms and 6.6% of bleeding aneurysms. There is no definite information about the pathogenesis and the lesion is thought to be more of a pseudoaneurysm. Atherosclerosis is said to be effective in the development of the aneurysm. ICA ligation can be performed surgically with or without clipping, wrapping, clip-wrapping, or by-pass. Endovascular treatment is also a good alternative. Dissecting aneurysms are the result of a longitudinal tear in the tunica media of the artery. They are more frequent in males and at middle age. The mortality rate for carotid and vertebral artery dissections is 5%. Carotid artery dissection is seen at a rate of 1-1.5/100,000 and vertebral artery dissection at 2.6/100,000 annually. Ischemic stroke is the most obvious finding but can take up to 30 days to appear. Subarachnoid hemorrhage, Horner syndrome, pain, cranial nerve paralysis can also be present in some patients. Some patients may be asymptomatic. There is a wide range of treatment methods, from medical treatment to surgery and endovascular treatment. Anahtar Kelimeler : Blister aneurysm, Dissecting aneurysm, Endovascular treatment