title: Oversized self-expanding stents as an alternative to flow-diverters for blister-like aneurysms.
abstract: OBJECTIVE
  Blister-like aneurysms (BLAs) are challenging to treat. Their friable nature makes them high risk for both traditional microsurgical and endovascular treatments. We discuss employing a single oversized self-expanding stent in the treatment of these treacherous lesions.
  
  
  METHODS
  A retrospective review from our institution was conducted. Five patients with BLAs were identified, who went on to be treated with a single oversized self-expanding stent, defined as 1 mm larger than the parent vessel, by the senior author (KRB), who is dual fellowship trained in both cerebrovascular/skull base microsurgery and endovascular neurosurgery. Additionally, a literature review was performed on BLAs treated with sole stenting and outcomes discussed.
  
  
  RESULTS
  Our five patients had complete aneurysm occlusion at long-term follow-up and all had good neurological outcomes. The literature review demonstrated that most aneurysms at long-term follow-up were either completed occluded or progressively becoming occluded, with patients overall having a good functional outcome based on the modified Rankin scale (mRS).
  
  
  CONCLUSIONS
  In our experience, oversized self-expanding stents are a treatment option that should be considered for BLAs. This strategy avoids the need for dual antiplatelet therapy and therefore increases its utility in the case of subarachnoid hemorrhage (SAH).
authors.forename: Ryan A
authors.initials: RA
authors.lastname: Grant
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Quon
authors.forename: Ketan R
authors.initials: KR
authors.lastname: Bulsara
mesh_terms: D000328:Adult; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
keywords: Blister-like aneurysms,; Endovascular therapy; Flow-diverter,; Neuroform,; Ruptured aneurysm,; Stent,; Subarachnoid hemorrhage,