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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.
CONCLUSIONS: 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.
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.
CONCLUSIONS: 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.
摘要：
■颈内动脉（ICA）的血泡动脉瘤（BBA）是具有高发病率和死亡率的挑战性病变。尽管对BBAs的研究在不同人群中有很好的记录，对西藏人口BBAs的研究极为罕见。本研究旨在评估BBA的特征，并与汉族人群进行比较，分析藏族人群的治疗方式和长期结局。
■回顾了我们机构2009年1月至2021年1月的ICABBA患者的特征。动脉瘤的特征，治疗方式，并发症,并对随访结果进行回顾性分析.
■共纳入130名接受治疗的ICABBA患者（41名藏族患者和89名汉族患者）。与汉族群体相比，藏族群体在ICA中表现出较高的BBAs比例(8.6%，41/477vs.1.6%,89/5563；p<0.05），高比例的血管痉挛(34.1%，14/41vs.6.7%,6/89；p=0.001），缺血事件的高风险(43.9%，18/41vs.22.5%,20/89；p<0.05)，和较低的良好结果比率(修改的Rankin量表，0-2）在1年的随访中（51.2%，21/41vs.74.2%,66/89；p<0.05）。多因素回归模型显示缺血事件对1年预后的预测有显著贡献。进一步的分析表明，显微外科手术和血管痉挛与缺血事件有关。
■与汉族患者相比，藏族人群的BBA发生率很高，缺血事件的高发生率，和高比例的不良结果。血管内途径在BBA患者中显示出更多的益处。
■回顾了我们机构2009年1月至2021年1月的ICABBA患者的特征。动脉瘤的特征，治疗方式，并发症,并对随访结果进行回顾性分析.
■共纳入130名接受治疗的ICABBA患者（41名藏族患者和89名汉族患者）。与汉族群体相比，藏族群体在ICA中表现出较高的BBAs比例(8.6%，41/477vs.1.6%,89/5563；p<0.05），高比例的血管痉挛(34.1%，14/41vs.6.7%,6/89；p=0.001），缺血事件的高风险(43.9%，18/41vs.22.5%,20/89；p<0.05)，和较低的良好结果比率(修改的Rankin量表，0-2）在1年的随访中（51.2%，21/41vs.74.2%,66/89；p<0.05）。多因素回归模型显示缺血事件对1年预后的预测有显著贡献。进一步的分析表明，显微外科手术和血管痉挛与缺血事件有关。
■与汉族患者相比，藏族人群的BBA发生率很高，缺血事件的高发生率，和高比例的不良结果。血管内途径在BBA患者中显示出更多的益处。
