Short-term outcomes of treatment for ruptured intracranial aneurysms using flow diverter and coiling: A single-center experience

The safety and feasibility of treating ruptured intracranial aneurysms with flow diverter (FD) deployment and coiling were evaluated in this study. The Hunt-Hess (HH) scale score was used to assess preoperative status in patients. Before endovascular treatment, a loading dose of aspirin and ticagrelor was administered. The Raymond-Roy classification (RRC) was applied to evaluate aneurysm occlusion grades. Follow-up outcomes were assessed using modified Rankin scale analysis and RRC grading. Fifty-two patients aged 57 ± 8.8 years with intracranial hemorrhage were enrolled. There were 53 aneurysms among 52 patients. After treatment with FD and coiling, immediate RRC occlusion grades were 1, 2, and 3 for 21 (39.6%, 21/53), 21 (39.6%, 21/53), and 11 (20.8%, 11/53) aneurysms, respectively. Among 52 patients, complications occurred in 21.2% (11/52), with 4 fatalities: 1 HH 3 and 1 HH 4 (vasospasm), 1 HH 3 (heart failure), and 1 HH 4 (pneumonia). Among the 48 surviving patients, follow-up modified Rankin scale scores were distributed as follows: 43 (89.6%, 43/48) with score 0, 3 (6.3%, 3/48) with score 1, 1 (2.1%, 1/48) with score 2, and 1 (2.1%, 1/48) with score 3. Forty-two patients with 42 aneurysms underwent follow-up angiography, revealing RRC occlusion grade 1 in 39 aneurysms and grade 2 in 3 aneurysms. In conclusion, endovascular treatment of ruptured aneurysms with FD and coiling demonstrates feasibility; however, severe complications-especially in patients with high HH scale scores-necessitate cautious evaluation.