The treatment experience of clipping blood blister-like aneurysm of internal carotid artery

LIU Zheng; ZHANG Shangming; CHEN Qizuan; WANG Shousen

Abstract：Objective The clipping of the ruptured blood blister-like aneurysm of internal carotid artery was discussed and analyzed.Methods The radiographic characteristics,treatment and prognosis were analyzed retrospectively in 22 patients with ruptured blood blister-like aneurysm and received the emergency aneurysm clipping.In the group,13 cases (59.1％) were confirmed that the wall of aneurysm was flimsy,and the color of the boundary between aneurysm neck and its parent artery was changed as "intermittent" significantly.The successful cases of clipping for one time were 10 cases,and the remaining 12 cases occurred the laceration of the neck of aneurysm;1 case reclipped but failed with slippage;successfully wrapped of parent artery was performed in 3 cases;isolated and bypass the parent artery were performed in two cases in acute phase and the rest of 7 cases were isolated the parent arteries alone.Results Nine cases were cured,severe disability in 2 cases,plant survival in 2 cases,and death in 9 cases.Conclusion The emergency operation of the clipping surgery should be considered carefully in aneurysm ruptured cases.The necessary surgery must observe the color and texture changes of the boundary wall between aneurysm neck and its parent artery under microscope,and determine whether the neck or the body of aneurysm avulsed after clipping surgery.The Minetstent treatment is preferred when the brain swelling subsided,and the high flow of intracranial bypass must be prepared when the interventional treatment is not implemented.