Endovascular treatment of intracranial blood blister-like aneurysms with the Willis covered stent: a case series.

Abstract

Background and purpose: To evaluate the safety, feasibility, and effectiveness of the Willis covered stent (WCS) in treating blood blister-like aneurysms (BBAs).

Materials and methods: Twenty-one consecutive patients with BBAs treated with the WCS were identified between July 2017 and July 2022. The demographic, clinical, and angiographic data and procedural-related complications were collected from the medical records and the operative reports.

Results: The present study included six men and fifteen women, with a mean age of 51.6 years (31-70 years). The immediate postoperative angiography demonstrated that the complete occlusion rate was 100%, with no endoleak. Ophthalmic artery (OA) occlusion occurred in five patients (23.8%). One patient developed delayed stent thrombosis on the third postoperative day. The mean angiographic follow-up time was 9.2 months (range 3-21 months). All twenty-one BBAs were occluded entirely, and the patency of the parent arteries was preserved. No aneurysm rupture or recurrence was found, and no retreatment was needed. Two patients developed mild to moderate asymptomatic in-stent stenosis. The clinical follow-up time was 20.0 months (range 15-33 months). Twenty patients had an mRS score of zero, and one had an mRS score of one.

Conclusions: Our series indicates that treating BBAs with WCSs was relatively safe and efficacious. However, the incidence of stent delivery failure and complications should not be neglected.