Flow diverters safe and feasible in ruptured blood blister-like aneurysms

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Published in the Journal of NeuroInterventional Surgery, the results of a small study of 11 patients has demonstrated that Silk flow diverter stents (Balt Extrusion) could be a safe and feasible treatment for fragile, difficult-to-treat blood blister-like aneurysms.

Kubilay Aydin, department of Radiology, Istanbul Faculty of Medicine, Istanbul, Turkey and colleagues say that blood blister-like aneurysms are associated with high morbidity and mortality surgical and endovascular methods such as clipping, clip wrapping, primary coiling, stent-assisted coiling.

With respect to this, the authors retrospectively reviewed patients who presented with subarachnoid haemorrhage caused by ruptured blood blister-like aneurysms who were treated with flow diverters.

Out of the 11 patients, nine were found to have blood blister-like aneurysms in the supraclinoid carotid artery and two in the basilar artery. Eight patients were treated with one flow diverter stent and two flow diverter stents were telescopically deployed in three patients.

The authors report that there were no acute complications in any of the cases. However, one patient died of septicaemia two weeks postprocedure (9%) and another had a minor stroke caused by parent artery thrombosis (9%).

At three and six months post stenting, control angiographies showed that there was complete occlusion of the aneurysms in all nine remaining patients (82%). Ten of the 11 patients (92%) had good clinical outcomes as measured by Modified Rankin Scale score of ≤2.

In their conclusion, Aydin et al say that flow diverter stent implantation in this small experience seemed to be a “safe and feasible alternative for the treatment of ruptured blood blister-like aneurysms.”