Discussion On The Endovascular Treatment Strategy Of Traumatic Blood Blister-like Aneurysms Of Internal Carotid Artery(6 Cases)

ObjectiveTo explore the formation mechanism and endovascular treatment strategy of traumatic blood blister-like aneurysm(BBA)of internal carotid artery.MethodsRetrospectively reviewed the clinical data of 6 cases with traumatic BBA of internal carotid artery.The formation mechanism,treatment strategy and prognosis were summarized and analyzed.ResultsTwo methods,the conventional stent-assisted coil embolization and the stent “rivet” technique embolization were used for aneurysms embolization.According to Raymond grading,the immediate embolization results were divided into grade I(n=1),and grade II(n=5).One patient had aneurysm recurrence and bleeding 2 weeks after embolization.Five patients of the 6 cases were followed-up clinically for 6 months,the modified Rankin scale(mRS)score were 0 in 3 cases,1 in 1 case,3 in 1case,respectively.The favorable prognosis rate was 4/5.And those 5 caseswere completely cured in imaging observed by the followed-up DSA.ConclusionIt is necessary to be highly vigilant for the formation of traumatic BBA of internal carotid artery for the patients with subarachnoid hemorrhage caused by rotating violence.The stent “rivet” technique embolization in the treatment of BBA is feasible and effective.It might help to reduce the risks of BBA recurrence and rebleeding,however,a large-sample Meta-analysis and clinical control study are still for fourther confirmation.