Editorial on a paper entitled “Combined suture and clipping for the reconstruction of a ruptured blister-like aneurysm”

Excerpt

Blister-like aneurysms are small, extremely fragile aneurysms at non-branching sites of cerebral blood vessels. The prevalence among all aneurysms is around 0.5% and the prevalence among ruptured aneurysms is 1.2%. In contrast to saccular aneurysms, they consist of only a thin layer of adventitia covered by a platelet plug, which covers a defect in the intima and media of the vessel wall. The underlying pathogenesis has been discussed to be atherosclerosis, hemodynamic stress, or dissection. Often, the vessel wall of the presumably intact blood vessel around the blister-like aneurysm is also affected and fragile. Thus, (re-) rupture of a blister-like aneurysm, both during microsurgical or endovascular treatment, may leave a large defect behind or may even destroy large parts of the circumference of the vessel wall. …