机构：[1]Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China四川大学华西医院[2]Neuroimmunology Unit, Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montréal, Quebec, Canada[3]Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran[4]Department of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China[5]Translational Centre for Oncoimmunology, Sichuan Cancer Hospital & Institute, University of Electronic and Science Technology of China, Chengdu, China四川省肿瘤医院[6]Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610000, Sichuan, China四川省人民医院四川省肿瘤医院
Background Many blood blister aneurysms (BBAs) have been documented with a rapid progression history in repeated angiography. The underlying mechanism and clinical significance remained elusive. This current study aims to clarify the clinical and histopathological differences between short-term progressive BBA and non-progressive BBAs. Methods and materials Eighty-one patients with BBAs were consecutively included for this single-center retrospective analysis. Clinical and radiological data on these patients were retrieved from 2017 to 2019. BBAs were defined as either progressive or non-progressive based on observed growth based on repeated imaging. Histopathological examinations of a saccular aneurysm, a progressive BBA, and a non-progressive BBA were conducted using representative aneurysm samples. Results Among all enrolled patients, 26 of the them were identified with progressive BBAs, while the other 55 with non-progressive BBAs. Progressive BBAs were diagnosed significantly earlier in angiography (3.36 +/- 0.61 vs. 6.53 +/- 1.31 days, p < 0.05) and showed a higher presence rate of daughter sacs (61.5 vs. 38.2%, p < 0.05). Three different progression patterns were identified. BBAs that developed daughter sac enlargement are diagnosed significantly later than BBAs exhibiting other progression patterns. Patients with progressive and non-progressive BBAs exhibited similar overall clinical outcomes and incidence for complications. For patients with non-progressive BBAs, microsurgery appears to be inferior to endovascular treatment, while for patients with progressive BBAs, the short-term outcomes between microsurgery and endovascular treatment were identical. Histopathological analysis revealed that both subtypes shared a similar pseudoaneurysms structure, but non-progressive BBAs had more histologically destructed aneurysm wall with less remnant fibrillar collagen in adventitia. Conclusions Progressive and non-progressive BBAs may not be distinct pathological lesions but represent different stages during the BBA development. Early intervention, regardless of treatment methods, is recommended for salvageable patients with progressive BBAs, but microsurgery should be performed with caution for non-progressive BBAs due to increased surgical risk.
基金：
National key R&D Program of China [2018YFA 0108604]; Sichuan International Science and Technology Innovation/Hong Kong, Macao and Taiwan Science and Technology Innovation Cooperation Key Projects [2020YFH0167]; Sichuan Cancer Hospital Overseas High-level Talent Introduction Fund [YBR2019002]
第一作者机构：[1]Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China[2]Neuroimmunology Unit, Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montréal, Quebec, Canada
共同第一作者：
通讯作者：
通讯机构：[1]Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China[5]Translational Centre for Oncoimmunology, Sichuan Cancer Hospital & Institute, University of Electronic and Science Technology of China, Chengdu, China[6]Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610000, Sichuan, China
推荐引用方式(GB/T 7714)：
Wen Dingke,Chen Ruiqi,Kieran Nicholas W.,et al.Comparison of clinical and histopathological characteristics of short-term progressive and non-progressive blood blister-like aneurysms[J].ACTA NEUROCHIRURGICA.2021,163(4):1167-1179.doi:10.1007/s00701-020-04697-9.
APA：
Wen, Dingke,Chen, Ruiqi,Kieran, Nicholas W.,Sharifian-Dorche, Maryam,Liu, Wu...&Ma, Lu.(2021).Comparison of clinical and histopathological characteristics of short-term progressive and non-progressive blood blister-like aneurysms.ACTA NEUROCHIRURGICA,163,(4)
MLA：
Wen, Dingke,et al."Comparison of clinical and histopathological characteristics of short-term progressive and non-progressive blood blister-like aneurysms".ACTA NEUROCHIRURGICA 163..4(2021):1167-1179
