{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T21:01:43Z","timestamp":1774040503917,"version":"3.50.1"},"reference-count":39,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Early repair of ruptured blood-blister aneurysms (BBAs) of the internal carotid artery (ICA) remains challenging. Although both surgical and endovascular therapies have been established, their relative superiority remains debated. The authors assessed their single-center experience and compared early deconstructive versus reconstructive repair and early reconstructive surgical versus endovascular repair of ruptured BBAs of the ICA.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The study included patients who underwent repair of ruptured BBAs of the ICA within 1 week after the ictus during a 20-year period. Multiple variables were recorded, including clinical state, severity of subarachnoid hemorrhage (SAH), characteristics of the BBA, treatment details, complication profile, need for secondary treatment, and clinical outcome.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>In total, 27 patients underwent early surgical (n = 16) or endovascular (n = 11) repair of BBAs at a median of 24 hours (range 9\u2013120 hours) after the ictus during the period from September 2000 to June 2021 (20.4 years). Primary deconstructive repair (n = 6) without bypass was accompanied by middle cerebral artery (MCA) territory infarction in 5 of 6 (83%) patients and a high mortality rate (4\/6 [67%]). Among the 21 patients who underwent early reconstructive repair, surgery was performed in 11 patients (clipping in 6 and clip-wrapping in 5 patients) and endovascular repair in 10 patients (flow diversion in 7 and stent\/stent-assisted coiling in 3 patients). No differences were found in complication profiles or clinical outcomes between the surgical and endovascular groups. The mortality rate was low (2\/21 [9.5%]), with 1 fatality in each group.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>From the authors\u2019 experience, both surgical and endovascular approaches permitted reconstructive repair of ruptured BBAs of the ICA, with no modality proving superior. Reconstructive treatment is preferable to ICA sacrifice, and if sacrifice is chosen, it should be accompanied with bypass surgery or delayed to the phase when cerebral vasospasm has resumed. The rare occurrence of this disease calls for prospective multicenter studies to improve treatment and delineate which modality is preferable in individual cases.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2022.3.jns2216","type":"journal-article","created":{"date-parts":[[2022,4,26]],"date-time":"2022-04-26T17:54:43Z","timestamp":1650995683000},"page":"1766-1775","source":"Crossref","is-referenced-by-count":8,"title":["Early surgical versus endovascular repair of ruptured blood-blister aneurysm of the internal carotid artery: a single-center 20-year experience"],"prefix":"10.3171","volume":"137","author":[{"given":"Per K.","family":"Eide","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Oslo University Hospital\u2014Rikshospitalet;"},{"name":"Institute of Clinical Medicine, Faculty of Medicine, University of Oslo; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelika","family":"Sorteberg","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Oslo University Hospital\u2014Rikshospitalet;"},{"name":"Institute of Clinical Medicine, Faculty of Medicine, University of Oslo; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terje","family":"Nome","sequence":"additional","affiliation":[{"name":"Department of Radiology, Oslo University Hospital\u2014Rikshospitalet, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P\u00e5l A.","family":"R\u00f8nning","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Oslo University Hospital\u2014Rikshospitalet;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilhelm","family":"Sorteberg","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Oslo University Hospital\u2014Rikshospitalet;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"662","DOI":"10.3171\/JNS\/2008\/108\/4\/0662","article-title":"Blood blister\u2013like aneurysms of the internal carotid artery trunk causing subarachnoid hemorrhage: treatment and outcome","volume":"108","author":"Meling TR","year":"2008","unstructured":"Meling TR, Sorteberg A, Bakke SJ, Sletteb\u00f8 H, Hernesniemi J, Sorteberg W. 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