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.

Flow diversion after aneurysmal subarachnoid hemorrhage (SAH) is the last treatment option for aneurysm occlusion when other methods of aneurysm treatment cannot be used because of the need for dual antiplatelet therapy. The authors' general protocol for treatment selection after aneurysmal SAH is provided to share with readers our approach to securing the aneurysm before embarking flow diversion for primary treatment or delayed adjunctive treatment to primary coiling. The authors' experience with flow diversion after aneurysmal SAH, review of pertinent literature, and the future of flow diversion after aneurysmal SAH are discussed.

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