title: Salvage surgical treatment for failed endovascular procedure of a blood blister-like aneurysm.
abstract: The blood blister-like aneurysm (BBA) of the internal carotid artery (ICA) is a rare but clinically important cause of subarachnoid hemorrhage (SAH), which accounts for 0.5% of incidences of ruptured intracranial aneurysms. BBA is a thin-walled, broad-based aneurysm that lacks an identifiable neck and is one of the most difficult lesions to treat. In this paper, a case is presented of a 57-year-old woman with SAH. Her cerebral angiography demonstrated a small BBA on the dorsal wall of her right ICA. Endovascular treatment that consisted of a stent-within-a-stent was attempted, but the replacement of the second stent failed, and the aneurysm became bigger. Surgery was performed by clipping the BBA with a Sundt slim-line encircling graft clip. The patient completely recovered with no complications. This treatment may be a salvageable option for BBA, especially when endovascular treatment has failed.
authors.affiliation: Department of Neurosurgery, Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea.
authors.forename: Tack Geun
authors.initials: TG
authors.lastname: Cho
authors.forename: Sung Nam
authors.initials: SN
authors.lastname: Hwang
authors.forename: Taek Kyun
authors.initials: TK
authors.lastname: Nam
authors.forename: Seung Won
authors.initials: SW
authors.lastname: Park