Dorsal Variant Blister Aneurysm Repair

"Dorsal Variant Blister Aneurysm Repair"

William T. Couldwell, MD, PhD, and Roukoz Chamoun, MD
Department of Neurosurgery, University of Utah, Salt Lake City, Utah

Dorsal variant proximal carotid blister aneurysms are treacherous lesions to manage. It is important to recognize this variant on preoperative angiographic imaging, in anticipation of surgical strategies for their treatment. Strategies include trapping the involved segment and revascularization if necessary. Other options include repair of the aneurysm rupture site directly. Given that these are not true berry aneurysms, repair of the rupture site involves wrapping or clip--grafting techniques. The technique used is demonstrated in the video and is a modified clip--wrap technique using woven polyester graft material.