title: Ventriculoperitoneal shunt in a patient with ruptured blister aneurysm treated with pipeline embolization device.
abstract: Cerebral spinal fluid (CSF) diversion is frequently required in patients with aneurysmal subarachnoid hemorrhage who develop subsequent hydrocephalus. Procedures such as external ventricular drain (EVD) and ventriculoperitoneal shunt (VPS) usually carry a very low rate of complications. However, as flow diverting stents such as Pipeline Embolization Device (PED) become more widely available, flow diverters are being used in treatment of some ruptured complex aneurysms. EVD and VPS placement in the setting of dual antiplatelet therapy (DAT) in these patients are associated with a significant risk of intracranial hemorrhage. We describe a management strategy and surgical technique that can minimize hemorrhagic complications associated with VPS in patients on DAT after treatment with flow diverting stents.
authors: Department of Neurosurgery, Rush University Medical Center, Chicago, IL, United States.
authors: Lee A
authors: 0000-0003-3497-3321
authors: LA
authors: Tan
authors: Department of Neurosurgery, Rush University Medical Center, Chicago, IL, United States.
authors: Carter S
authors: CS
authors: Gerard
authors: Department of Neurosurgery, Rush University Medical Center, Chicago, IL, United States.
authors: Kiffon M
authors: KM
authors: Keigher
authors: Department of Neurosurgery, Rush University Medical Center, Chicago, IL, United States.
authors: Roham
authors: R
authors: Moftakhar
authors: Department of Neurosurgery, Rush University Medical Center, Chicago, IL, United States.
authors: Demetrius K
authors: DK
authors: Lopes
keywords: Intracranial aneurysm; Stents; Subarachnoid hemorrhage; Ventriculoperitoneal shunt