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Endovascular treatment of anterior communicating artery ruptured blister-like aneurysm with flowdiverter stent

Journal of Neurology & Stroke
Guilherme de Palma Abrão,1 Matheus Miranda Barbosa,2 Márcio Chaves Pedro Marques,2 Luísa Borges de Souza,2 Bruno Lima Pessoa3


Blister-like aneurysms (BLAs) are rare lesions, described as a small sac with thin wall and broad-based neck. Although its typical location is the dorsal wall of the supraclinoid internal carotid artery (ICA) at non-branching sites, atypical locations as the anterior cerebral artery (ACA) are reported. Due to its fragile walls, BLAs are associated with diffuse subarachnoid hemorrhage (SAH) and tend to rebleed, thus requiring emergency treatment. Endovascular and surgical approaches in acute setting are both considered challenging due to aneurysm morphological features. Here we describe a case of a ruptured blister-like aneurysm of the anterior communicating artery treated by endovascular exclusion of the Anterior Communicating Artery (AComA) using micro-coils and deployment of flow diverter stent (FDS) in the left anterior cerebral artery. Control angiogram confirmed exclusion of the lesion and patency of the left ACA. Patient presented no new neurological deficits or procedure complications. We suggest that in selected cases, FDS treatment for blood blister-like aneurysm in atypical locations can be safe and effective when no other treatment is available.


: blister-like aneurysm, flow-diverter stent, subarachnoid hemorrhage