To analyze and evaluate the effect of interventional treatment with stent assisted coiling of BBAs (blood blister-like aneurysms) arising from the dorsal wall of internal carotid artery (ICA).

We retrospectively analyzed the clinical data of 9 patients with BBAs protruding from the dorsal wall of ICA who underwent stent assisted coiling at Neurosurgery Department of Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology from January 2011 to December 2014. CTA was performed immediately after completion of endovascular procedure and modified Rankin scale (mRS) was used for outcome assessment at discharge. DSA was performed for recurrence detection at 3-month, 6-month, 1-year and 2-year follow-up.

Among all 9 cases, 1 case underwent double overlapping stent-assisted coiling and single stent-assisted coiling was performed in 8 cases. CTA immediately after operation demonstrated complete occlusion in 7 cases and little residual aneurysm in the other 2 cases. Follow-up was conducted for all except 1 patient who developed rebleeding at 5 hours post operation and was subsequently in persistent vegetative state. The mRS score at discharge was 0 in 5 cases, 1 in 2 cases, 2 in 1 case and 5 in 1 case. Eight patients were followed up for a period of 3 to 38 months with an average of 13.6 months. Recurrence was found in 2 cases with little residual flow in the aneurysm neck including 1 undergoing second stent-assisted coiling and 1 receiving placement of weaved stent, and both recovered well. No recurrence was reported in the other 6 cases.

Endovascular treatment with stent assisted coiling is feasible and effective for BBAs arising from the dorsal wall of ICA.

Aneurysm; Carotid artery, internal; Stents; Endovascular treatment; Treatment outcome