{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T03:00:10Z","timestamp":1760151610246,"version":"build-2065373602"},"reference-count":28,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg A Cent Eur Neurosurg"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Blood blister-like aneurysms (BBA) are rare vascular lesions with challenging treatment. While direct surgery has been the primary technique for treating BBA, there has been a shift toward endovascular methods in recent years. This article presents a retrospective case series of patients treated with direct surgery at our center over a 6-year period.<\/jats:p><jats:p>Patients who underwent surgery for BBA from 2014 to 2019 were evaluated. Data on surgical procedures, complications, and clinical outcomes were obtained from patients' medical records. Additionally, patients were contacted to provide updates on their treatment outcomes.<\/jats:p><jats:p>A total of 17 patients were treated for BBA during the study period. All cases presented with subarachnoid hemorrhage and were treated using the clipping method. Intraoperative rupture occurred in 11 patients. Additionally, internal carotid artery sacrificing was done in five patients due to avulsion during surgery. Of these 17 patients, 11 (64.7%) had favorable outcomes following surgery, while the mortality rate was 29.4% (5 patients).<\/jats:p><jats:p>The rate of favorable outcomes and mortality associated with the direct surgery technique at our center was comparable to results from other centers. Further studies are required to determine the optimal method for treating BBA.<\/jats:p>","DOI":"10.1055\/a-2568-4665","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T19:56:07Z","timestamp":1743191767000},"page":"509-515","source":"Crossref","is-referenced-by-count":0,"title":["Report of the Outcome of 6-year Blood Blister-Like Aneurysm Treatment Using Clipping Technique: A Single-Center Experience"],"prefix":"10.1055","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6986-952X","authenticated-orcid":false,"given":"Iman","family":"Ahrari","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdelkarim","family":"Rahmanian","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meisam","family":"Eqbal","sequence":"additional","affiliation":[{"name":"Department of QHSE, Sinopec Medical Center, Sinopec International Petroleum Corporation, Yadavaran Oil Field, Ahwaz, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahsa","family":"Ghavipisheh","sequence":"additional","affiliation":[{"name":"Psychiatry Department, Shiraz University of Medical Sciences, Shiraz, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Namjoo-Moghadam","sequence":"additional","affiliation":[{"name":"Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sobhan","family":"Ahrari","sequence":"additional","affiliation":[{"name":"Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ehsan Mohammad","family":"Hosseini","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Jamali","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"2767","DOI":"10.1007\/s10143-020-01463-4","article-title":"Ruptured blood blister like aneurysm: does the best therapeutic option really exist?","volume":"44","author":"R Aboukais","year":"2021","journal-title":"Neurosurg Rev"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"e82","DOI":"10.1016\/j.wneu.2021.06.129","article-title":"Comparison of blister aneurysm treatment techniques: a systematic review and meta-analysis","volume":"154","author":"V E Sanchez","year":"2021","journal-title":"World Neurosurg"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"438","DOI":"10.23736\/S0390-5616.16.02937-4","article-title":"Reconstructive endovascular treatment of a ruptured blood blister-like aneurysm of anterior communicating artery","volume":"61","author":"S Peschillo","year":"2017","journal-title":"J Neurosurg Sci"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.ejrad.2013.09.017","article-title":"Blood blister-like aneurysms: single center experience and systematic literature review","volume":"83","author":"A M Gonzalez","year":"2014","journal-title":"Eur J Radiol"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1177\/159101991001600304","article-title":"Endovascular treatment of a ruptured blood blister-like aneurysm with a flow-diverting stent","volume":"16","author":"S Rasskazoff","year":"2010","journal-title":"Interv Neuroradiol"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"NP60","DOI":"10.1177\/1747493016641953","article-title":"Endovascular pure electrocoagulation of intracranial perforator blister-like aneurysm not accessible to microcatheter-new approach to treat small vessel hemorrhage disease","volume":"11","author":"Y Jiang","year":"2016","journal-title":"Int J Stroke"},{"issue":"07","key":"ref7","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/j.jocn.2007.03.012","article-title":"Successful treatment of a blood blister-like aneurysm of the internal carotid artery by trapping with a high-flow bypass","volume":"15","author":"A Kawashima","year":"2008","journal-title":"J Clin Neurosci"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1017\/S0317167100000901","article-title":"Endovascular treatment of a \u201cblister-like\u201d aneurysm of the internal carotid artery","volume":"27","author":"P D McNeely","year":"2000","journal-title":"Can J Neurol Sci"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"100005","DOI":"10.1016\/j.wnsx.2018.100005","article-title":"Clipping on crossed wrapping method for ruptured blood blister-like aneurysm of the internal carotid artery: technical note and long-term results","volume":"2","author":"T Nishi","year":"2019","journal-title":"World Neurosurg X"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1227\/NEU.0000000000001259","article-title":"Blister aneurysms of the internal carotid artery: microsurgical results and management strategy","volume":"80","author":"C M Owen","year":"2017","journal-title":"Neurosurgery"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"245","DOI":"10.7461\/jcen.2021.E2020.12.001","article-title":"Slip clip after successful microsurgery of a blister aneurysm: should bypass always be the first option?","volume":"23","author":"A LC Paiva","year":"2021","journal-title":"J Cerebrovasc Endovasc Neurosurg"},{"issue":"05","key":"ref12","doi-asserted-by":"crossref","first-page":"812","DOI":"10.3171\/jns.2007.106.5.812","article-title":"Endovascular treatment of blood blister-like aneurysms of the internal carotid artery","volume":"106","author":"J H Park","year":"2007","journal-title":"J Neurosurg"},{"issue":"11","key":"ref13","first-page":"21786","article-title":"Direct clipping of a blister-like aneurysm in the supraclinoid segment of the internal carotid artery: a clinical analysis of nine cases","volume":"8","author":"J Yu","year":"2015","journal-title":"Int J Clin Exp Med"},{"issue":"05","key":"ref14","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1136\/neurintsurg-2015-011665","article-title":"Towards a new treatment paradigm for ruptured blood blister-like aneurysms of the internal carotid artery? A rapid systematic review","volume":"8","author":"T Szmuda","year":"2016","journal-title":"J Neurointerv Surg"},{"issue":"03","key":"ref15","doi-asserted-by":"crossref","first-page":"171","DOI":"10.7461\/jcen.2017.19.3.171","article-title":"The blood blister like-aneurysm: usefulness of sundt clip","volume":"19","author":"T J Park","year":"2017","journal-title":"J Cerebrovasc Endovasc Neurosurg"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1016\/j.wneu.2017.06.129","article-title":"Outcome after subarachnoid hemorrhage from blood blister-like aneurysm rupture depends on age and aneurysm morphology","volume":"105","author":"J Konczalla","year":"2017","journal-title":"World Neurosurg"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"1103138","DOI":"10.3389\/fneur.2023.1103138","article-title":"Endovascular intervention vs. microsurgery on the prognosis of anterior circulation blood blister-like aneurysm: a cohort study","volume":"14","author":"H Tan","year":"2023","journal-title":"Front Neurol"},{"issue":"09","key":"ref18","doi-asserted-by":"crossref","first-page":"105968","DOI":"10.1016\/j.jstrokecerebrovasdis.2021.105968","article-title":"Contemporary treatment of intracranial blood blister aneurysms - a systematic review","volume":"30","author":"M Nasra","year":"2021","journal-title":"J Stroke Cerebrovasc Dis"},{"issue":"06","key":"ref19","doi-asserted-by":"crossref","first-page":"3539","DOI":"10.1007\/s10143-021-01542-0","article-title":"Real-world treatment results for ruptured blood-blister aneurysm of the internal carotid artery: analysis of a Japanese nationwide multicenter study","volume":"44","author":"Y Egashira","year":"2021","journal-title":"Neurosurg Rev"},{"issue":"02","key":"ref20","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1007\/s10143-020-01302-6","article-title":"The role of EC-IC bypass in ICA blood blister aneurysms-a systematic review","volume":"44","author":"T R Meling","year":"2021","journal-title":"Neurosurg Rev"},{"issue":"01","key":"ref21","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1007\/s10143-024-02764-8","article-title":"Flow diverting stent monotherapy as the best choice in the treatment of intracranial blood blister-like aneurysms: a systematic review","volume":"47","author":"M Ghorbani","year":"2024","journal-title":"Neurosurg Rev"},{"issue":"04","key":"ref22","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1007\/s00062-022-01160-3","article-title":"Stent-assisted coiling vs. flow diverter for treating blood blister-like aneurysms: a proportion meta-analysis","volume":"32","author":"J Lee","year":"2022","journal-title":"Clin Neuroradiol"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.wneu.2020.08.089","article-title":"Comparison of bypass and non-bypass surgical treatments for internal carotid artery blood blister-like aneurysms: a meta-analysis of efficacy, safety, and outcomes","volume":"144","author":"V Balik","year":"2020","journal-title":"World Neurosurg"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.jocn.2021.07.055","article-title":"Meta-analysis on the treatment options and outcomes of carotid blood blister aneurysms","volume":"92","author":"A K Roy","year":"2021","journal-title":"J Clin Neurosci"},{"issue":"04","key":"ref25","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1055\/s-0041-1731756","article-title":"Wrap-clipping for patients with ruptured blood blister-like aneurysms of the internal carotid artery: case series and literature review","volume":"83","author":"X D Zhai","year":"2022","journal-title":"J Neurol Surg A Cent Eur Neurosurg"},{"issue":"01","key":"ref26","doi-asserted-by":"crossref","first-page":"1427","DOI":"10.1097\/JS9.0000000000002072","article-title":"Comparative analysis of characteristics, management, and clinical outcome of blood blister-like aneurysms treated with flow diverter devices: a systematic review and meta-analysis of 30 studies","volume":"111","author":"D Jin","year":"2025","journal-title":"Int J Surg"},{"issue":"09","key":"ref27","doi-asserted-by":"crossref","first-page":"e02241","DOI":"10.1016\/j.heliyon.2019.e02241","article-title":"Flow diverter embolization device for endovascular treatment of ruptured blister and wide necked very small aneurysms","volume":"5","author":"M Ghorbani","year":"2019","journal-title":"Heliyon"},{"issue":"05","key":"ref28","doi-asserted-by":"crossref","first-page":"856","DOI":"10.3174\/ajnr.A4606","article-title":"A systematic review and meta-analysis of treatment and outcome of blister-like aneurysms","volume":"37","author":"S Peschillo","year":"2016","journal-title":"AJNR Am J Neuroradiol"}],"container-title":["Journal of Neurological Surgery Part A: Central European Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2568-4665.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:42:21Z","timestamp":1760136141000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2568-4665"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,28]]},"references-count":28,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2025,10,10]]},"published-print":{"date-parts":[[2025,11]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2568-4665","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2193-6315","2193-6323"],"issn-type":[{"type":"print","value":"2193-6315"},{"type":"electronic","value":"2193-6323"}],"subject":[],"published-other":{"date-parts":[[2025,3,28]]},"published":{"date-parts":[[2025,3,28]]}}}