{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:55:11Z","timestamp":1786125311289,"version":"build-2736575974"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2021,6,7]],"date-time":"2021-06-07T00:00:00Z","timestamp":1623024000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Dorsal internal carotid artery (ICA) blister aneurysms are an uncommon aneurysm variant constituting 0.3% to 1% of intracranial aneurysms and can be due to ulceration, atherosclerosis, or dissection.\n                    <jats:sup>1-3<\/jats:sup>\n                    Despite its rarity, it carries a high risk of rupture with an estimation of 0.9% to 6.5% among intracranial aneurysms.\n                    <jats:sup>1,2<\/jats:sup>\n                    Blister aneurysms are small in size, have no distinguishable neck, and have a friable wall that can easily rupture if manipulated, hence the difficulty in its treatment utilizing both microsurgical and endovascular techniques.\n                    <jats:sup>1,2,4-6<\/jats:sup>\n                    Endovascular coiling of these lesions may not be adequate due to the broad-based size; stenting requires the use of antiplatelet medications, which could lead to rebleeding; flow diversion takes longer to exert its treatment effect.\n                    <jats:sup>1,4<\/jats:sup>\n                    Conversely, microsurgical management carries a higher intraoperative rupture rate.\n                    <jats:sup>2<\/jats:sup>\n                    Microsurgical options include clipping, clip reconstruction, trapping with bypass, and wrapping.\n                    <jats:sup>4,7<\/jats:sup>\n                    We present a case of a 38-yr-old man who presented with a ruptured right dorsal ICA blister aneurysm treated with microsurgical trapping with intraoperative flow measurements. We demonstrate how the use of quantitative intraoperative flow measurements allows confident sacrifice of the supraclinoid ICA. We also demonstrate in contrast another case example of utilizing a clip-graft repair. The patient remained unchanged with an intact neurological exam, and postoperative imaging showed no aneurysm remnant and patent anterior choroidal artery. We review the literature and management of dorsal ICA aneurysms.\n                    <jats:sup>8-15<\/jats:sup>\n                    We also review the technical nuances and different endovascular and microsurgical treatments that can be used for this condition.\n                  <\/jats:p>\n                  <jats:p>\u2003The patient gave informed consent for the procedure and verbal consent to the publication.<\/jats:p>","DOI":"10.1093\/ons\/opab196","type":"journal-article","created":{"date-parts":[[2021,6,7]],"date-time":"2021-06-07T16:34:06Z","timestamp":1623083646000},"page":"E244-E245","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Microsurgical Clip Trapping of Dorsal Internal Carotid Artery Blister Ruptured Aneurysm: 2-Dimensional Operative Video"],"prefix":"10.1227","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4099-089X","authenticated-orcid":false,"given":"Nickalus R","family":"Khan","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Turki","family":"Elarjani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Cajigas","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques J","family":"Morcos","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,9]]},"reference":[{"key":"bib1-20250822","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.clineuro.2019.05.006","article-title":"Blister aneurysms of the internal carotid artery: surgical treatment and management outcome from a single center experience","volume":"182","author":"Cezar-Junior","year":"2019","journal-title":"Clin Neurol Neurosurg"},{"issue":"6","key":"bib2-20250822","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.3171\/2016.9.JNS161526","article-title":"Microsurgical versus endovascular interventions for blood-blister aneurysms of the internal carotid artery: systematic review of literature and meta-analysis on safety and efficacy","volume":"127","author":"Shah","year":"2017","journal-title":"J Neurosurg"},{"issue":"1","key":"bib3-20250822","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":"Gonzalez","year":"2014","journal-title":"Eur J Radiol"},{"issue":"2","key":"bib4-20250822","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":"Owen","year":"2017","journal-title":"Neurosurgery"},{"issue":"4","key":"bib5-20250822","doi-asserted-by":"crossref","first-page":"260","DOI":"10.3340\/jkns.2009.45.4.260","article-title":"Ideal internal carotid artery trapping technique without bypass in a patient with insufficient collateral 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aneurysms","volume":"10","author":"Kazumata","year":"2014","journal-title":"Neurosurgery"},{"issue":"3","key":"bib9-20250822","doi-asserted-by":"crossref","first-page":"378","DOI":"10.3109\/02688697.2011.631617","article-title":"Rupture of symptomatic blood blister-like aneurysm of the internal carotid artery: clinical experience and management outcome","volume":"26","author":"Yu-Tse","year":"2012","journal-title":"Br J Neurosurg"},{"issue":"2","key":"bib10-20250822","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1007\/s00701-008-0165-5","article-title":"Surgical strategies for ruptured blister-like aneurysms arising from the internal carotid artery: a clinical analysis of 18 consecutive patients","volume":"151","author":"Lee","year":"2009","journal-title":"Acta Neurochir (Wien)"},{"issue":"6","key":"bib11-20250822","doi-asserted-by":"crossref","first-page":"E11","DOI":"10.3171\/2017.3.FOCUS1757","article-title":"Pipeline flow diversion of ruptured blister aneurysms of the supraclinoid carotid artery using a single-device strategy","volume":"42","author":"Ryan","year":"2017","journal-title":"Neurosurg Focus"},{"issue":"5","key":"bib12-20250822","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1177\/1591019917720805","article-title":"Treatment of ruptured blood blister aneurysms using primary flow-diverter stenting with considerations for adjunctive coiling: a single-centre experience and literature review","volume":"23","author":"Yang","year":"2017","journal-title":"Interv Neuroradiol"},{"issue":"12","key":"bib13-20250822","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1007\/s00234-017-1936-6","article-title":"Flow diverter treatment of cerebral blister aneurysms","volume":"59","author":"Cerejo","year":"2017","journal-title":"Neuroradiology"},{"issue":"5","key":"bib14-20250822","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1227\/NEU.0000000000000309","article-title":"Treatment of blister-like aneurysms with the pipeline 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