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Table 1 Review of reported intraoperative aneurysm microsuture cases

From: Intraoperative rupture of blood blister-like aneurysm: a case report and review of literature

Reference number

Age/sex

SAH grade

Location

Surgical strategy

Stenosis of artery

Patency confirmation

Outcomes

Vashu et al. [24]

14/F

WFNS Grade II

Right supraclinoid ICA aneurysm

8/0 Prolene 4 stitches—20-min clipping + barbiturate

No

CTA

No neurological deficit—no recurrence at 11 months follow-up

Vashu et al. [24]

48/F

WFNS Grade I

Right supraclinoid ICA aneurysm

7/0 Prolene 4 stitches—23-min clipping + another 28-min clipping + barbiturate

No

DSA

GOS-5 at 5 months follow-up, left side limb weakness 4/5

Yanaka et al. [25]

46/F

H&H III

Right supraclinoid ICA aneurysm

8/0 nylon 2 stitches—Surgicel + fibrin glue + encircling clip

Spasm

DSA

Returned to normal activities at 3 months follow-up

Lee et al. [7]

46/F

H&H II

Left dorsolateral ICA

Suture—temporary clip time 36 min

NM

NM

Global infarction—death

Otani et al. [17]

40/F

H&H V

Right ICA

Clip on wrapping with suture

Spasm

NM

Moderate disability

Park [26]

58/F

 

Right superior to medial wall ICA aneurysm

8/0 polypropylene

No

DSA

mRs 3 at 3 months follow-up

Joo et al. [23]

30/M

H&H III

Left ICA

Suture tear with 8/0 nylon + wrapping + clipping—20 min

ICA occluded

DSA

Discrete hemiparesis (4/5)

Joo et al. [23]

33/M

FISHER III

Right supraclinoid ICA aneurysm

Suture with 8/0 nylon + wrapping + clipping

NO

DSA

Good

Our case

68/M

H&H II

Right supraclinoid ICA aneurysm

8/0 Prolene 3 sutures—22-min clipping

NM

NM

mRS 3 at 8 months follow-up

  1. As we can see from Table 1, male to female ratio is 2:1, age distribution of 14–68 years old (mean age of 43 years old). Seven out of these 9 cases (77.8 %) were from the right side, and right supraclinoid ICA aneurysms seem to be more common. 8/0 Prolene sutures were preferred for suturing, and average time of temporary clipping of ICA was 26 min. All the BBLA in this review was intraoperatively ruptured and then sutured. No reports of rebleeding or recurrence were noted, and the postoperative outcomes were good except in one case where the patient died
  2. M male, F female, WFNS World Federation of Neurosurgeons Subarachnoid Hemorrhage (SAH) Grading System, H&H Hunt and Hess SAH Scale, FISHER Fisher SAH Grade, GOS Glasgow Outcome Scale, mRs modified Rankin scale, NM not mentioned, CTA computed tomography angiography, DSA digital subtraction angiography