Predicting Recurrence of Blood Blister-Like Aneurysms: The Importance of Aneurysmal Neck Area.

Abstract

Blood blister-like aneurysms (BBAs) are distinct aneurysms that mostly develop as small, wide-based structures at the supraclinoid segment of the internal carotid artery, often leading to subarachnoid hemorrhage and causing diagnostic and therapeutic challenges. This study aimed to identify the diagnostic indicators associated with postoperative recurrence of BBAs. We retrospectively evaluated the clinical history, angiographic features, three-dimensional parameters, treatment methods, and outcomes of 23 patients with BBA treated at our center. Cases were categorized into three outcomes: no recurrence, stable recurrence, and progressive recurrence, and these groups were compared. Significant differences were observed in the width, neck length, and neck area between the no recurrence and recurrence groups. The progressive recurrence group had a larger neck area. The no recurrence and stable recurrence groups had higher aspect and K ratios. Our research highlighted that these parameters could be potential indicators of aneurysm recurrence. Furthermore, our findings suggested that patients with a larger neck area, lower aspect ratio, and K ratio might require additional intervention to prevent aneurysm recurrence.