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Utility of CT angiography in the identification and characterization of supraclinoid internal carotid artery blister aneurysms.

Publication ,  Journal Article
Gaughen, JR; Raghavan, P; Jensen, ME; Hasan, D; Pfeffer, AN; Evans, AJ
Published in: AJNR Am J Neuroradiol
April 2010

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.

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Published In

AJNR Am J Neuroradiol

DOI

EISSN

1936-959X

Publication Date

April 2010

Volume

31

Issue

4

Start / End Page

640 / 644

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Subarachnoid Hemorrhage
  • Stents
  • Sensitivity and Specificity
  • Retrospective Studies
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Intracranial Aneurysm
  • Imaging, Three-Dimensional
 

Citation

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Gaughen, J. R., Raghavan, P., Jensen, M. E., Hasan, D., Pfeffer, A. N., & Evans, A. J. (2010). Utility of CT angiography in the identification and characterization of supraclinoid internal carotid artery blister aneurysms. AJNR Am J Neuroradiol, 31(4), 640–644. https://doi.org/10.3174/ajnr.A1893
Gaughen, J. R., P. Raghavan, M. E. Jensen, D. Hasan, A. N. Pfeffer, and A. J. Evans. “Utility of CT angiography in the identification and characterization of supraclinoid internal carotid artery blister aneurysms.AJNR Am J Neuroradiol 31, no. 4 (April 2010): 640–44. https://doi.org/10.3174/ajnr.A1893.
Gaughen JR, Raghavan P, Jensen ME, Hasan D, Pfeffer AN, Evans AJ. Utility of CT angiography in the identification and characterization of supraclinoid internal carotid artery blister aneurysms. AJNR Am J Neuroradiol. 2010 Apr;31(4):640–4.
Gaughen, J. R., et al. “Utility of CT angiography in the identification and characterization of supraclinoid internal carotid artery blister aneurysms.AJNR Am J Neuroradiol, vol. 31, no. 4, Apr. 2010, pp. 640–44. Pubmed, doi:10.3174/ajnr.A1893.
Gaughen JR, Raghavan P, Jensen ME, Hasan D, Pfeffer AN, Evans AJ. Utility of CT angiography in the identification and characterization of supraclinoid internal carotid artery blister aneurysms. AJNR Am J Neuroradiol. 2010 Apr;31(4):640–644.

Published In

AJNR Am J Neuroradiol

DOI

EISSN

1936-959X

Publication Date

April 2010

Volume

31

Issue

4

Start / End Page

640 / 644

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Subarachnoid Hemorrhage
  • Stents
  • Sensitivity and Specificity
  • Retrospective Studies
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Intracranial Aneurysm
  • Imaging, Three-Dimensional