A Case of Blood Blister-Like Aneurysm with Subarachnoid Hemorrhage after Endovascular Mechanical Thrombectomy of Internal Carotid Artery

Mitsuru Kojima; Masanao Tabuse; Shunpei Azami; Yutaka Mine; Takuro Hayashi

doi:10.3995/jstroke.11383

January 1, 2026NosotchuOpen Access

A Case of Blood Blister-Like Aneurysm with Subarachnoid Hemorrhage after Endovascular Mechanical Thrombectomy of Internal Carotid Artery

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Key Points

This case examines the formation of a blood blister-like aneurysm (BBA) and subsequent subarachnoid hemorrhage following endovascular treatment for internal carotid artery occlusion.
An 80-year-old female underwent mechanical thrombectomy for right ICA occlusion.
A BBA was formed and rapidly enlarged after the procedure, leading to rebleeding before further planned intervention.
Clinical findings suggest possible vascular endothelial injury due to the catheter or stent retrieval.
BBA formation was confirmed post-thrombectomy, resulting in fatal rebleeding before scheduled intervention.
No previous cases of BBA after thrombectomy have been published, making this report significant for vascular interventions.
Emphasized the need for careful selection of devices and early post-operative imaging to monitor for BBA.

Implication

Case report highlights the risks of blood blister-like aneurysm formation after thrombectomy in the elderly, indicating a need for careful monitoring.

Abstract

症例は，80歳女性．右ICA閉塞に対する機械的脳血栓回収術後，遅発性にくも膜下出血を来し，右ICA前壁に血豆状動脈瘤（blood blister-like aneurysm: BBA）の形成および急速増大を認めた．ステント併用コイル塞栓術を企図したが，手術前日に再出血し死亡転帰となった．本症例では吸引カテーテル誘導，もしくはステントリトリーバー牽引による血管内皮損傷がBBA形成に関与した可能性が示唆された．機械的脳血栓回収術後にBBAを形成した報告は渉猟しえた限り，自験例のみであった．本症例は脳血管内治療全般において，注意喚起を含んだ報告といえる．治療時のBBA形成リスクを念頭に置いたデバイス選択や血管愛護的操作の必要性は当然のこと，最終DSA画像の詳細な確認を行い，関連領域の血管壁異常に対する術後早期からの画像フォローによりBBA形成の有無を捉える必要がある．

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Cite This Study

Kojima et al. (2026) studied this question.

synapsesocial.com/papers/6a192c8bfab5b468c4415710 https://doi.org/10.3995/jstroke.11383

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A Case of Blood Blister-Like Aneurysm with Subarachnoid Hemorrhage after Endovascular Mechanical Thrombectomy of Internal Carotid Artery

Key Points

Implication

Abstract

Discussion

Cite This Study

A Case of Blood Blister-Like Aneurysm with Subarachnoid Hemorrhage after Endovascular Mechanical Thrombectomy of Internal Carotid Artery

Key Points

Implication

Abstract

Discussion

Cite This Study

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