Francesca Incandela, Sergio Abrignani, Laura Geraci, Cristina Gallo, Cesare Gagliardo, Giuseppe Craparo
Blister-like aneurysms (BLA) are a rare half-dome-shaped aneurysm, with a broad-based appearance, originating more often from a non-branching site of the supraclinoid internal carotid artery (ICA). They are sometimes difficult to recognize due to their morphological changes and high tendency to rupture. BLAs are often undiagnosed and may be detected only after repeated angiograms in the case of acute subarachnoid hemorrhage (SAH). BLA are life-threatening and no consensus has so far been reached on the best management strategy. We describe a patient with a BLA in the left ICA successfully treated by flow-diverting device using intraoperative abciximab bolus, with successful results. Recently, the use of flow-diverting device (FDD), has offered a very promising option for treatment even for ruptured BLA, with high long-term occlusion and low complication rates. However, double antiplatelet therapy is required and still represents a major constraint in a case of SAH, so that standardized multicenter studies are still needed.
