Blister aneurysms

Blister aneurysms of the supraclinoid internal carotid artery are difficult to treat with endovascular and surgical techniques due to their marked fragility, tiny size, and poorly defined necks. Surgical techniques aimed at treating these lesions include bypass, clip-reinforced wrapping, and direct surgical clipping. Endovascular treatment options include parent artery occlusion, stent-assisted coil embolization, and flow diverter treatment. Over the past decade, endovascular therapy has emerged as the primary treatment modality of these lesions with relatively low complication rates and acceptable rates of complete/near complete occlusion. Introduction of flow diverter technologies has revolutionized treatment of these lesions as one can reconstruct the supraclinoid parent artery without having to manipulate or introduce a catheter and wire into the aneurysm. However, such treatments are not without their complications especially in the setting of subarachnoid hemorrhage due to the fact that patients must be placed on dual antiplatelet therapy.