Combined endovascular/neurosurgical therapy of blister-like distal internal carotid aneurysms.

OBJECTIVE To describe a novel therapeutic strategy for the treatment of "blister-like" aneurysms of the distal internal carotid artery (ICA). Direct surgical treatments of these fragile lesions have been associated with generally poor outcomes. METHODS Two consecutive patients presenting with acute subarachnoid hemorrhage from "blister-like" aneurysms were treated with preliminary balloon occlusion of the ICA, followed by surgical trapping of the ICA beyond the aneurysm. RESULTS The treatment resulted in complete thrombosis of both aneurysms with no clinical complications. CONCLUSION This combined endovascular-neurosurgical approach offers a controlled, safer alternative to primary surgical therapy of "blister-like" aneurysms.