Document Detail

Utility of CT angiography in the identification and characterization of supraclinoid internal carotid artery blister aneurysms.
MedLine Citation:
PMID:  19942699     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: Blister aneurysms of the supraclinoid ICA represent a rare but potentially catastrophic cause of SAH, often presenting both diagnostic and therapeutic dilemmas. We explore the utility of CTA in the identification and characterization of ICA blister aneurysms. MATERIALS AND METHODS: We performed a retrospective review of catheter cerebral angiograms obtained at our institution over a 12-month period for evaluation of SAH, identifying 6 cases of ICA blister aneurysms. All patients underwent CTA and DSA for evaluation of SAH. The reports from the CTA and DSA studies were reviewed to identify aneurysms correctly diagnosed prospectively. Retrospective review of the CTA and DSA images was also performed. Review of the interpretations and images was performed for any follow-up studies. RESULTS: All 6 patients presented with SAH, diagnosed by head CT. All patients subsequently underwent CTA prior to DSA evaluation. All 6 aneurysms were identified prospectively on initial DSA imaging. Of the 6 blister aneurysms, 4 (67%) were identified prospectively; and 5 (83%), retrospectively on CTA. All 6 patients underwent endovascular treatment with stent placement. Four of the 6 aneurysms underwent follow-up CTA (range, 9-22 days), including the 2 aneurysms that had been unidentifiable preprocedurally. All 4 blister aneurysms were seen postprocedurally by DSA. Three of these 4 (75%) residual aneurysms were detected by CTA (both prospectively and retrospectively). CONCLUSIONS: In the presence of SAH and otherwise negative findings on CTA, a catheter cerebral angiogram should be performed to absolutely exclude an ICA blister aneurysm.
J R Gaughen; P Raghavan; M E Jensen; D Hasan; A N Pfeffer; A J Evans
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Publication Detail:
Type:  Journal Article     Date:  2009-11-26
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  31     ISSN:  1936-959X     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-13     Completed Date:  2010-07-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  640-4     Citation Subset:  IM    
Department of Radiology, University of Virginia Health System, Charlottesville, USA.
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MeSH Terms
Aneurysm, Ruptured / radiography*,  therapy
Angiography, Digital Subtraction*
Carotid Artery Diseases / radiography*,  therapy
Carotid Artery, Internal / radiography*
Cerebral Angiography / methods*
Cone-Beam Computed Tomography*
Diagnosis, Differential
Embolization, Therapeutic
Follow-Up Studies
Image Processing, Computer-Assisted*
Imaging, Three-Dimensional*
Intracranial Aneurysm / radiography*,  therapy
Middle Aged
Retrospective Studies
Sensitivity and Specificity
Subarachnoid Hemorrhage / radiography,  therapy
Tomography, X-Ray Computed / methods*

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