title: Overlapping stents for blood blister-like aneurysms of the internal carotid artery.
abstract: OBJECTIVE
  Blood blister-like aneurysms (BBAs) are unique due to their high risk of recurrent bleeding associated with their fragile neck. The best treatment for BBAs is still controversial. This paper sought to evaluate the safety and efficacy of stent-assisted coiling and subsequent overlapping stents (SAC+OS) in the treatment of BBAs.
  
  
  METHODS
  Fifteen consecutive patients with ruptured BBAs managed with SAC+OS were enrolled in this study. The clinical characteristics, procedural data, angiographic outcome, and follow-up results were reviewed.
  
  
  RESULTS
  SAC+OS were successfully performed in all 15 cases. The instant angiographic result was total occlusion in 6 cases, residual neck in 7 cases, and residual aneurysm in 2 cases. Angiographic follow-ups revealed total occlusion in all 6 cases treated by triple or quadruple stents, and 6 of 9 cases treated by double stents. Major recanalization was detected in 3 cases treated by double stents. The modified Rankin Scale score at 4-52 months follow-up (23.8 months on average) was 0 in 6 cases, 1 in 8 cases, and 3 in one case.
  
  
  CONCLUSIONS
  Stent-assisted coiling and subsequent overlapping stents are feasible and safe for BBAs. It can be helpful to further decrease the risk of recanalization with more stents. Early angiographic follow-up within 2 weeks is recommended.
authors.affiliation: Department of Neurosurgery, Changhai hospital, 168 Changhai Road, Shanghai 200433, PR China.
authors.forename: Yi-Bin
authors.initials: YB
authors.lastname: Fang
authors.affiliation: Department of Neurosurgery, Changhai hospital, 168 Changhai Road, Shanghai 200433, PR China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, Changhai hospital, 168 Changhai Road, Shanghai 200433, PR China.
authors.forename: Yi-Na
authors.initials: YN
authors.lastname: Wu
authors.affiliation: Department of Neurosurgery, Changhai hospital, 168 Changhai Road, Shanghai 200433, PR China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Changhai hospital, 168 Changhai Road, Shanghai 200433, PR China.
authors.forename: Peng-Fei
authors.initials: PF
authors.lastname: Yang
authors.affiliation: Department of Neurosurgery, Changhai hospital, 168 Changhai Road, Shanghai 200433, PR China.
authors.forename: Wen-Yuan
authors.initials: WY
authors.lastname: Zhao
authors.affiliation: Department of Neurosurgery, Changhai hospital, 168 Changhai Road, Shanghai 200433, PR China.
authors.forename: Qing-Hai
authors.initials: QH
authors.lastname: Huang
authors.affiliation: Department of Neurosurgery, Changhai hospital, 168 Changhai Road, Shanghai 200433, PR China.
authors.forename: Bo
authors.initials: B
authors.lastname: Hong
authors.affiliation: Department of Neurosurgery, Changhai hospital, 168 Changhai Road, Shanghai 200433, PR China. Electronic address: xuyichyy@163.com.
authors.forename: Yi
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Neurosurgery, Changhai hospital, 168 Changhai Road, Shanghai 200433, PR China. Electronic address: chstroke@163.com.
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Liu
mesh_terms: D000328:Adult; D017542:Aneurysm, Ruptured / Q000150:complications / Q000601:surgery*; D001768:Blister / Q000175:diagnosis / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000601:surgery*; D002533:Cerebral Angiography / Q000379:methods; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult
keywords: Aneurysm; Endovascular intervention; Overlapping stents