title: Flow diverters and a tale of two aneurysms.
abstract: Flow-diverting devices offer an exciting alternative for the management of large and giant intracranial aneurysms. However, the risk and mechanism of delayed aneurysmal rupture and hemorrhage following placement of these devices are not clearly understood. Two patients with similar symptomatic giant paraclinoid internal carotid artery aneurysms are described. Both patients were treated with SILK flow-diverting devices. In both patients the SILK device was placed without technical complication. The first patient continued to do well 1 year postoperatively with complete aneurysm occlusion. The second patient had a delayed subarachnoid hemorrhage despite markedly decreased filling of the aneurysm immediately following the procedure. Flow-diverting devices are an exciting technology which provide an alternative treatment modality in the management of giant intracranial aneurysms. However, caution must be exercised as the risks of delayed complications have yet to be fully elucidated. Similar aneurysms may have drastically different outcomes due to the unpredictability of this technology.
authors.affiliation: Yale University School of Medicine, New Haven, Connecticut 06520, USA.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Kuzmik
authors.forename: Theresa
authors.initials: T
authors.lastname: Williamson
authors.forename: Asiri
authors.initials: A
authors.lastname: Ediriwickrema
authors.forename: Ahmed
authors.initials: A
authors.lastname: Andeejani
authors.forename: Ketan R
authors.initials: KR
authors.lastname: Bulsara
mesh_terms: D021721:Balloon Occlusion / Q000379:methods*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000628:therapy*; D017809:Fatal Outcome; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy*; D008875:Middle Aged; D011859:Radiography