Faculty, Staff and Student Publications

Language

English

Publication Date

11-28-2025

Journal

Interventional Neuroradiology

DOI

10.1177/15910199251398360

PMID

41313592

PMCID

PMC12662770

PubMedCentral® Posted Date

11-28-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Background

Flow diverter (FD) use has become a popular method for treating intracranial aneurysms, but evidence in acutely ruptured blood blister-like and dissecting morphologies is limited. Furthermore, there is little evidence regarding the role of short-term follow-up imaging to assess aneurysm stability. This study is a single-center retrospective review of dissecting aneurysms treated by FD, with an analysis of short-term follow-up angiograms to guide post-treatment management.

Methods

Our single-center retrospective review included all patients from 2016 to 2024 with spontaneous subarachnoid hemorrhage from blood blister-like and dissecting aneurysms who underwent treatment with an FD. Outcomes included re-rupture, treatment failure, re-treatment, aneurysm morphological changes, and ischemic/hemorrhagic events. Short-term, inpatient angiograms were used to assess early response to treatment, and long-term follow-up angiogram, >4 months, was used to assess long-term aneurysm obliteration.

Results

Twenty-eight patients underwent FD for treatment of their ruptured dissecting aneurysm. Twelve patients (43%) were treated with coiling plus FD. Treatment failure occurred in four patients (14%). Placement of additional FDs in a second procedure occurred in three patients (11%). Thromboembolic events occurred in five patients (18%). Hemorrhagic complications, not including aneurysm re-rupture, occurred in six patients (21%). Short-term aneurysm improvement occurred in 17 patients (63%). Thirteen patients had long-term follow-up, with 11 (85%) demonstrating complete occlusion.

Conclusions

Flow diversion is a reasonable technique for treating ruptured dissecting aneurysms. Risks are moderate and include short-term aneurysm growth and re-rupture. Early post-treatment angiography is suggested to help identify aneurysm growth and the need for re-treatment.

Keywords

Flow diversion, pipeline, aneurysm, digital subtraction angiography, short-term outcomes

Published Open-Access

yes

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