Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Blood-Blister Aneurysms of the Internal Carotid Artery in Tibetan and Han Populations : A Retrospective Observational Study

  • Bowen Huang (Department of Neurosurgery, West China Hospital of Sichuan University) ;
  • Yanming Ren (Department of Neurosurgery, West China Hospital of Sichuan University) ;
  • Hao Liu (Department of Neurosurgery, West China Hospital of Sichuan University) ;
  • Anqi Xiao (Department of Neurosurgery, West China Hospital of Sichuan University) ;
  • Lunxin Liu (Department of Neurosurgery, West China Hospital of Sichuan University) ;
  • Hong Sun (Department of Neurosurgery, West China Hospital of Sichuan University) ;
  • Yi Liu (Department of Neurosurgery, West China Hospital of Sichuan University) ;
  • Hao Li (Department of Neurosurgery, West China Hospital of Sichuan University) ;
  • Lu Ma (Department of Neurosurgery, West China Hospital of Sichuan University) ;
  • Chang-Wei Zhang (Department of Neurosurgery, West China Hospital of Sichuan University) ;
  • Chao-Hua Wang (Department of Neurosurgery, West China Hospital of Sichuan University) ;
  • Min He (Department of Neurosurgery, West China Hospital of Sichuan University) ;
  • Yuekang Zhang (Department of Neurosurgery, West China Hospital of Sichuan University) ;
  • Chao You (Department of Neurosurgery, West China Hospital of Sichuan University) ;
  • Jin Li (Department of Neurosurgery, West China Hospital of Sichuan University)
  • Received : 2023.07.06
  • Accepted : 2023.10.07
  • Published : 2024.05.01
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Abstract

Objective : Blood-blister aneurysms (BBAs) of the internal carotid artery (ICA) are challenging lesions with high morbidity and mortality rates. Although research on BBAs is well documented in different populations, the study of BBAs in the Tibetan population is extremely rare. This study aimed to evaluate the characteristics of BBAs and analyze the treatment modalities and long-term outcomes in the Tibetan population in comparison with the Han population. Methods : The characteristics of patients with BBAs of the ICA from January 2009 to January 2021 at our institution were reviewed. The features of aneurysms, treatment modalities, complications, and follow-up outcomes were retrospectively analyzed. Results : A total of 130 patients (41 Tibetan and 89 Han patients) with BBAs of the ICA who underwent treatment were enrolled. Compared with the Han group, the Tibetan group significantly demonstrated a high ratio of BBAs among ICAs (8.6%, 41/477 vs. 1.6%, 89/5563; p<0.05), a high ratio of vasospasm (34.1%, 14/41 vs. 6.7%, 6/89; p=0.001), a high risk of ischemic events (43.9%, 18/41 vs. 22.5%, 20/89; p<0.05), and a low ratio of good outcomes (modified Rankin scale, 0-2) at the 1-year follow-up (51.2%, 21/41 vs. 74.2%, 66/89; p<0.05). The multivariate regression model showed that ischemic events significantly contributed to the prediction of outcomes at 1 year. Further analysis revealed that microsurgery and vasospasm were associated with ischemic events. Conclusion : In comparison with Han patients, the Tibetan population had a high ratio of BBA occurrence, a high incidence of ischemic events, and a high ratio of poor outcomes. The endovascular approach showed more benefits in BBA patients.

Keywords

Acknowledgement

Sichuan Province Science and Technology Support Program (CN). 2019YFS0397; Natural Science Foundation of China. 81571131.

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