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Dorsal variant blister aneurysm repair
William T Couldwell1, Roukoz Chamoun1
1Department of Neurosurgery, University of Utah, Salt Lake City, Utah.
Neurosurgical Focus
|May 29, 2015
Summary
Dorsal variant proximal carotid blister aneurysms require specific surgical approaches. A modified clip-wrap technique using polyester graft material offers a direct repair option for these challenging lesions.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Neuroradiology
Background:
- Dorsal variant proximal carotid blister aneurysms are rare and challenging cerebrovascular lesions.
- Accurate preoperative angiographic identification is crucial for effective surgical planning.
Purpose of the Study:
- To present a case of a ruptured dorsal variant blister aneurysm in a young woman.
- To demonstrate a modified clip-wrap technique for direct aneurysm repair.
Main Methods:
- Preoperative imaging to identify aneurysm characteristics.
- Surgical intervention using a modified clip-wrap technique with woven polyester graft.
- Intraoperative assessment of vessel patency using Doppler and indocyanine green angiography.
- Monitoring of somatosensory and motor evoked potentials.
Main Results:
- Successful direct repair of the blister aneurysm using the modified clip-wrap technique.
- Demonstration of a viable surgical strategy for this specific aneurysm subtype.
Conclusions:
- The modified clip-wrap technique is an effective method for direct repair of dorsal variant proximal carotid blister aneurysms.
- Artery sacrifice with or without bypass serves as a salvage option if direct repair fails.
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