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Research ArticleNeurointerventionF

Utility of CT Angiography in the Identification and Characterization of Supraclinoid Internal Carotid Artery Blister Aneurysms

J.R. Gaughen, P. Raghavan, M.E. Jensen, D. Hasan, A.N. Pfeffer and A.J. Evans
American Journal of Neuroradiology April 2010, 31 (4) 640-644; DOI: https://doi.org/10.3174/ajnr.A1893
J.R. Gaughen Jr
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P. Raghavan
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M.E. Jensen
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D. Hasan
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A.N. Pfeffer
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A.J. Evans
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    Fig 1.

    Left supraclinoid ICA blister aneurysm. Volume-rendered 3D CTA image shows the characteristic morphology of supraclinoid ICA blister aneurysms (white arrow): wide-neck shallow outpouching of the medial wall of the left supraclinoid ICA.

  • Fig 2.
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    Fig 2.

    Left supraclinoid ICA blister aneurysm. Coronal MIP CTA image (A) shows the morphology of the blister aneurysm (white arrow), which closely resembles its DSA counterpart (black arrow, B).

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    Fig 3.

    Left supraclinoid ICA blister aneurysm posttreatment. Coronal MIP CTA image (A) shows the morphology of the residual blister aneurysm (white arrow), which again resembles its DSA counterpart (black arrowhead, B), though the dome of the aneurysm appears slightly more prominent on the DSA study (B). Note that the radiopaque tines of the overlapping stents used in the treatment are clearly seen on the CTA image (black arrows, A) but not on the DSA image.

  • Fig 4.
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    Fig 4.

    Right supraclinoid ICA blister aneurysm. At presentation, this blister aneurysm (black arrow, A) manifests as a subtle shallow outpouching, which becomes progressively larger and more saccular at 2-week (B) and 3-month (C) follow-ups, despite treatment with overlapping stents and subsequent coil embolization.

  • Fig 5.
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    Fig 5.

    Right supraclinoid ICA blister aneurysm. This aneurysm (black arrow) was not identified prospectively but appears visible on retrospective review. A, Volume-rendered 3D CTA image shows a poor imaging technique, with a relatively low resolution and prominent step-off artifacts. B, The correlative DSA clearly delineates the small blister aneurysm (black arrow).

  • Fig 6.
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    Fig 6.

    Right supraclinoid ICA blister aneurysm posttreatment. With adequate imaging and postprocessing parameters on the short-term CTA follow-up (following treatment of the blister aneurysm in Fig 5), the residual blister aneurysm (white arrow) is much more clearly identified (A and B) and closely resembled the appearance of the aneurysm on the correlative DSA (black arrow, C). Note the radiopaque tines of the overlapping stents used in the treatment identified on the CTA images (black arrowheads, A).

  • Fig 7.
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    Fig 7.

    Right supraclinoid ICA blister aneurysm, pre- and posttreatment. The blister aneurysm is not detectable on initial CTA images (A and B) but is clearly delineated on the correlative DSA image (black arrow, C). On the short-term posttreatment CTAs (D and E), the residual aneurysm remains invisible, while it is still clearly seen on the correlative posttreatment DSA image (black arrow, F).

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American Journal of Neuroradiology: 31 (4)
American Journal of Neuroradiology
Vol. 31, Issue 4
1 Apr 2010
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Cite this article
J.R. Gaughen, P. Raghavan, M.E. Jensen, D. Hasan, A.N. Pfeffer, A.J. Evans
Utility of CT Angiography in the Identification and Characterization of Supraclinoid Internal Carotid Artery Blister Aneurysms
American Journal of Neuroradiology Apr 2010, 31 (4) 640-644; DOI: 10.3174/ajnr.A1893

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Utility of CT Angiography in the Identification and Characterization of Supraclinoid Internal Carotid Artery Blister Aneurysms
J.R. Gaughen, P. Raghavan, M.E. Jensen, D. Hasan, A.N. Pfeffer, A.J. Evans
American Journal of Neuroradiology Apr 2010, 31 (4) 640-644; DOI: 10.3174/ajnr.A1893
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  • Endovascular Treatment Using Predominantly Stent-Assisted Coil Embolization and Antiplatelet and Anticoagulation Management of Ruptured Blood Blister-Like Aneurysms
  • The Efficacy of Endovascular Stenting in the Treatment of Supraclinoid Internal Carotid Artery Blister Aneurysms Using a Stent-in-Stent Technique
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