S Peschillo1, D Cannizzaro2, A Caporlingua2, P Missori2. 1. From the Department of Neurology and Psychiatry, Endovascular Neurosurgery/Interventional Neuroradiology (S.P.) simone.peschillo@gmail.com. 2. Neurosurgery (D.C., A.C., P.M.), "Sapienza," University of Rome, Rome, Italy.
Abstract
BACKGROUND AND PURPOSE: Blister-like aneurysms are uncommon but challenging lesions. Their small size and atypical location often make the diagnosis difficult. Microsurgery and endovascular procedures have been used for their treatment, but there is no consensus on the best treatment technique. We conducted a systematic review and meta-analysis of treatments and outcomes of these vascular lesions. MATERIALS AND METHODS: We reviewed English-language articles on "blood blister-like aneurysms" published between January 1997 and November 2014. All studies reporting patients with these aneurysms treated with surgery, endovascular procedures, or combined therapy with data on treatment modalities and clinical and/or angiographic outcomes were selected, including case reports and series. We performed a meta-analysis on the 2 largest treatment groups (surgery and endovascular management). RESULTS: Sixty studies with 334 patients met our inclusion criteria. Surgery was performed in 114 patients (34.2%), and endovascular treatment, in 199 patients (59.5%). A combined treatment was used in 19 patients (5.7%). A favorable outcome (mRS 0-2) was reported in 67.4% and 78.9% of patients treated with surgery and with endovascular therapy, respectively (P = .034). CONCLUSIONS: Blister-like aneurysms are challenging vascular lesions. The choice of treatment method must be based on the initial clinical presentation and an analysis of the radiologic features of the lesion to select the best technique. Endovascular treatment seems to have lower morbidity and mortality and provides a better outcome compared with surgical approaches. Further prospective studies must be performed to confirm such interesting results.
BACKGROUND AND PURPOSE: Blister-like aneurysms are uncommon but challenging lesions. Their small size and atypical location often make the diagnosis difficult. Microsurgery and endovascular procedures have been used for their treatment, but there is no consensus on the best treatment technique. We conducted a systematic review and meta-analysis of treatments and outcomes of these vascular lesions. MATERIALS AND METHODS: We reviewed English-language articles on "blood blister-like aneurysms" published between January 1997 and November 2014. All studies reporting patients with these aneurysms treated with surgery, endovascular procedures, or combined therapy with data on treatment modalities and clinical and/or angiographic outcomes were selected, including case reports and series. We performed a meta-analysis on the 2 largest treatment groups (surgery and endovascular management). RESULTS: Sixty studies with 334 patients met our inclusion criteria. Surgery was performed in 114 patients (34.2%), and endovascular treatment, in 199 patients (59.5%). A combined treatment was used in 19 patients (5.7%). A favorable outcome (mRS 0-2) was reported in 67.4% and 78.9% of patients treated with surgery and with endovascular therapy, respectively (P = .034). CONCLUSIONS: Blister-like aneurysms are challenging vascular lesions. The choice of treatment method must be based on the initial clinical presentation and an analysis of the radiologic features of the lesion to select the best technique. Endovascular treatment seems to have lower morbidity and mortality and provides a better outcome compared with surgical approaches. Further prospective studies must be performed to confirm such interesting results.
Authors: Simone Peschillo; P Missori; M Piano; D Cannizzaro; G Guidetti; A Santoro; M Cenzato Journal: Neurosurg Rev Date: 2014-10-18 Impact factor: 3.042
Authors: Ana Marcos Gonzalez; Ana Paula Narata; Hasan Yilmaz; Philippe Bijlenga; Ivan Radovanovic; Karl Schaller; Karl-Olof Lovblad; Vitor Mendes Pereira Journal: Eur J Radiol Date: 2013-10-06 Impact factor: 3.528
Authors: Rabih Aboukais; Marie Charlotte Tétard; Antoine Devalckeneer; Pierre Boussemart; Philippe Bourgeois; Nicolas Bricout; Barbara Verbraeken; Tomas Menovsky; Xavier Leclerc; Jean-Paul Lejeune Journal: Neurosurg Rev Date: 2021-01-07 Impact factor: 3.042
Authors: V Hellstern; M Aguilar-Pérez; M AlMatter; P Bhogal; E Henkes; O Ganslandt; H Henkes Journal: Interv Neuroradiol Date: 2018-07-12 Impact factor: 1.610
Authors: A Scerrati; J Visani; M E Flacco; L Ricciardi; S Trungu; A Raco; F Dones; P De Bonis; C L Sturiale Journal: AJNR Am J Neuroradiol Date: 2020-12-24 Impact factor: 3.825