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Flow Diversion after Aneurysmal Subarachnoid Hemorrhage.

Sabareesh K Natarajan1, Hussain Shallwani1, Vernard S Fennell1

  • 1Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY 14203, USA; Gates Vascular Institute, Kaleida Health, 100 High Street, Buffalo, NY 14203, USA; University at Buffalo, State University of New York, 875 Ellicott Street, 5th Floor, Buffalo, NY 14203, USA; Neurosurgical Stroke Service, Kaleida Health, 100 High Street, Buffalo, NY 14203, USA; Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 3435 Main Street, Buffalo, NY 14214, USA; Neuroendovascular Services, Gates Vascular Institute, Kaleida Health, Buffalo, 100 High Street, Buffalo, NY, USA.

Neurosurgery Clinics of North America
|June 11, 2017
PubMed
Summary

Flow diversion is a crucial treatment for aneurysmal subarachnoid hemorrhage (SAH) when other methods fail. This approach offers a viable option for aneurysm occlusion, especially when dual antiplatelet therapy is required.

Keywords:
Cerebral aneurysmFlow diversionPipeline Embolization DeviceSubarachnoid hemorrhage

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Area of Science:

  • Neurosurgery
  • Interventional Neurology
  • Vascular Neurology

Background:

  • Aneurysmal subarachnoid hemorrhage (SAH) presents significant treatment challenges.
  • Flow diversion is considered when standard aneurysm occlusion methods are not feasible.
  • Dual antiplatelet therapy is a key consideration in treatment selection.

Purpose of the Study:

  • To present a protocol for selecting flow diversion in aneurysmal SAH.
  • To outline the authors' approach to aneurysm securing before flow diversion.
  • To discuss flow diversion as primary or adjunctive therapy.

Main Methods:

  • Review of the authors' experience with flow diversion post-SAH.
  • Analysis of treatment selection protocols.
  • Literature review on flow diversion efficacy and safety.

Main Results:

  • Flow diversion serves as a last-line treatment for aneurysm occlusion.
  • The protocol guides the use of flow diversion as primary or adjunctive therapy.
  • Experience and literature support flow diversion's role in complex SAH cases.

Conclusions:

  • Flow diversion is an important option for managing aneurysmal SAH.
  • A structured approach to treatment selection is vital for optimal outcomes.
  • Future research should continue to explore the role of flow diversion in SAH management.