{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T14:18:11Z","timestamp":1790777891689,"version":"4.1.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2019,11,4]],"date-time":"2019-11-04T00:00:00Z","timestamp":1572825600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,11,4]],"date-time":"2019-11-04T00:00:00Z","timestamp":1572825600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Neuroradiol"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Reports about the use of flow diverter stents (FDS) in the acute setting of subarachnoid hemorrhage (SAH) are limited. This article presents a\u00a0single center experiences based on 45\u00a0consecutive cases with emphasis on complication rates and clinical and radiologic outcomes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A prospectively maintained database of all cases treated with FDS as a\u00a0stand-alone or adjunct device was retrospectively reviewed. All patients treated within 30\u00a0days of SAH were included. Records were made of clinical presentation, details of endovascular treatment, procedural complications, clinical outcome, and degree of occlusion on follow-up.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In this study 45 patients (48.9% females; mean age 58.8\u202f\u00b1\u200912.4 years) were included. Flow diversion was performed after a\u00a0median of 4\u00a0days. The procedural complication rate was 13.3% resulting in 2.2% permanent morbidities and 4.4% mortalities. No major hemorrhagic complications related to antiplatelet therapy were recorded. Immediate complete occlusion was achieved in 13.3%. Among survivors, complete occlusion was achieved in 94.6%. Excellent clinical outcome was recorded in 68.9% and 81.6% of the total population and survivors, respectively. There were no records of rebleeding from the target lesions.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Flow diversion is an attractive alternative strategy for management of acutely ruptured aneurysms with high rates of delayed complete occlusion and acceptable complication rates.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00062-019-00846-5","type":"journal-article","created":{"date-parts":[[2019,11,4]],"date-time":"2019-11-04T17:03:17Z","timestamp":1572886997000},"page":"835-842","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Flow Diversion for Treatment of Acutely Ruptured Intracranial Aneurysms"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6405-656X","authenticated-orcid":false,"given":"Muhammad","family":"AlMatter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Aguilar P\u00e9rez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Hellstern","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Goran","family":"Mitrovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Ganslandt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hansj\u00f6rg","family":"B\u00e4zner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Henkes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,11,4]]},"reference":[{"key":"846_CR1","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1148\/radiol.13120099","volume":"267","author":"T Becke","year":"2013","unstructured":"Becske T, Kallmes DF, Saatci I, McDougall CG, Szikora I, Lanzino G, Moran CJ, Woo HH, Lopes DK, Berez AL, Cher DJ, Siddiqui AH, Levy EI, Albuquerque FC, Fiorella DJ, Berentei Z, Marosfoi M, Cekirge SH, Nelson PK.. Pipeline for uncoilable or failed aneurysms: results from a\u00a0multicenter clinical trial. Radiology. 2013;267:858\u201368.","journal-title":"Radiology"},{"key":"846_CR2","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1161\/STROKEAHA.112.678151","volume":"44","author":"W Brinjikji","year":"2013","unstructured":"Brinjikji\u00a0W, Murad\u00a0MH, Lanzino\u00a0G, Cloft\u00a0HJ, Kallmes\u00a0DF. Endovascular treatment of intracranial aneurysms with flow diverters: a meta-analysis. Stroke. 2013;44:442\u20137.","journal-title":"Stroke"},{"key":"846_CR3","doi-asserted-by":"publisher","first-page":"81","DOI":"10.3171\/2015.6.JNS15311","volume":"127","author":"T Becske","year":"2017","unstructured":"Becske T, Potts MB, Shapiro M, Kallmes DF, Brinjikji W, Saatci I, McDougall CG, Szikora I, Lanzino G, Moran CJ, Woo HH, Lopes DK, Berez AL, Cher DJ, Siddiqui AH, Levy EI, Albuquerque FC, Fiorella DJ, Berentei Z, Marosf\u00f6i M, Cekirge SH, Nelson PK. Pipeline for uncoilable or failed aneurysms: 3\u2011year follow-up results. J\u00a0Neurosurg. 2017;127:81\u20138.","journal-title":"J Neurosurg"},{"key":"846_CR4","doi-asserted-by":"publisher","first-page":"775","DOI":"10.3171\/2016.8.JNS16467","volume":"127","author":"DF Kallmes","year":"2017","unstructured":"Kallmes DF, Brinjikji W, Cekirge S, Fiorella D, Hanel RA, Jabbour P, Lopes D, Lylyk P, McDougall CG, Siddiqui A. Safety and efficacy of the pipeline embolization device for treatment of intracranial aneurysms: a\u00a0pooled analysis of 3 large studies. J\u00a0Neurosurg. 2017;127:775\u201380.","journal-title":"J Neurosurg"},{"key":"846_CR5","doi-asserted-by":"publisher","first-page":"432","DOI":"10.3174\/ajnr.A5101","volume":"38","author":"J Raymond","year":"2017","unstructured":"Raymond J, Klink R, Chagnon M, Barnwell SL, Evans AJ, Mocco J, Hoh BH, Turk AS, Turner RD, Desal H, Fiorella D, Bracard S, Weill A, Guilbert F, Lanthier S, Fox AJ, Darsaut TE, White PM, Roy D. Hydrogel versus bare platinum coils in patients with large or recurrent aneurysms prone to recurrence after endovascular treatment: a randomized controlled trial. AJNR Am J Neuroradiol. 2017;38:432\u201341.","journal-title":"AJNR Am J Neuroradiol"},{"key":"846_CR6","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1002\/ana.25484","volume":"85","author":"MMJ Chua","year":"2019","unstructured":"Chua MMJ, Silveira L, Moore J, Pereira VM, Thomas AJ, Dmytriw AA. Flow diversion for treatment of intracranial aneurysms: mechanism and implications. Ann Neurol. 2019;85:793\u2013800.","journal-title":"Ann Neurol"},{"key":"846_CR7","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1016\/j.nec.2017.02.011","volume":"28","author":"SK Natarajan","year":"2017","unstructured":"Natarajan SK, Shallwani H, Fennell VS, Beecher JS, Shakir HJ, Davies JM, Snyder KV, Siddiqui AH, Levy EI. Flow diversion after aneurysmal subarachnoid hemorrhage. Neurosurg Clin N Am. 2017;28:375\u201388.","journal-title":"Neurosurg Clin N Am"},{"key":"846_CR8","doi-asserted-by":"publisher","first-page":"1669","DOI":"10.3174\/ajnr.A5730","volume":"39","author":"F Cagnazzo","year":"2018","unstructured":"Cagnazzo\u00a0F, di Carlo\u00a0DT, Cappucci\u00a0M, Lefevre\u00a0P\u2011H, Costalat\u00a0V, Perrini\u00a0P. Acutely ruptured intracranial aneurysms treated with flow-diverter stents: a systematic review and meta-analysis. AJNR Am J Neuroradiol. 2018;39:1669\u201375.","journal-title":"AJNR Am J Neuroradiol"},{"issue":"1","key":"846_CR9","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1227\/NEU.0b013e3182315ee3","volume":"70","author":"AR Martin","year":"2012","unstructured":"Martin\u00a0AR, Cruz\u00a0JP, Matouk\u00a0CC, Spears\u00a0J, Marotta\u00a0TR. The pipeline flow-diverting stent for exclusion of ruptured intracranial aneurysms with difficult morphologies. Neurosurgery. 2012;70:21\u20138.","journal-title":"Neurosurgery"},{"key":"846_CR10","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1148\/radiol.10092209","volume":"256","author":"L Pierot","year":"2010","unstructured":"Pierot\u00a0L, Cognard\u00a0C, Anxionnat\u00a0R, Ricolfi\u00a0F, CLARITY Investigators. Ruptured intracranial aneurysms: factors affecting the rate and outcome of endovascular treatment complications in a series of 782 patients (CLARITY study). Radiology. 2010;256:916\u201323.","journal-title":"Radiology"},{"key":"846_CR11","doi-asserted-by":"publisher","first-page":"108","DOI":"10.3174\/ajnr.A4111","volume":"36","author":"DF Kallmes","year":"2015","unstructured":"Kallmes DF, Hanel R, Lopes D, Boccardi E, Bonaf\u00e9 A, Cekirge S, Fiorella D, Jabbour P, Levy E, McDougall C, Siddiqui A, Szikora I, Woo H, Albuquerque F, Bozorgchami H, Dashti SR, Delgado Almandoz JE, Kelly ME, Turner R 4th, Woodward BK, Brinjikji W, Lanzino G, Lylyk P. International retrospective study of the pipeline embolization device: a multicenter aneurysm treatment study. AJNR Am J Neuroradiol. 2015;36:108\u201315.","journal-title":"AJNR Am J Neuroradiol"},{"issue":"4","key":"846_CR12","doi-asserted-by":"publisher","first-page":"60975","DOI":"10.1016\/S0140-6736","volume":"1","author":"AJ Molyneux","year":"2015","unstructured":"Molyneux\u00a0AJ, Birks\u00a0J, Clarke\u00a0A, Sneade\u00a0M, Kerr\u00a0RSC. The durability of endovascular coiling versus neurosurgical clipping of ruptured cerebral aneurysms: 18 year follow-up of the UK cohort of the International Subarachnoid Aneurysm Trial (ISAT). Lancet. 2015;385:691-7.","journal-title":"Lancet"},{"key":"846_CR13","doi-asserted-by":"publisher","first-page":"1683","DOI":"10.1016\/j.ejrad.2014.05.029","volume":"83","author":"F Briganti","year":"2014","unstructured":"Briganti F, Napoli M, Leone G, Marseglia M, Mariniello G, Caranci F, Tortora F, Maiuri F. Treatment of intracranial aneurysms by flow diverter devices: long-term results from a\u00a0single center. Eur J Radiol. 2014;83:1683\u201390.","journal-title":"Eur J Radiol"},{"key":"846_CR14","doi-asserted-by":"publisher","first-page":"1165","DOI":"10.1007\/s00701-019-03912-6","volume":"161","author":"B Korkmazer","year":"2019","unstructured":"Korkmazer\u00a0B, Kocak\u00a0B, Islak\u00a0C, Kocer\u00a0N, Kizilkilic\u00a0O. Long-term results of flow diversion in the treatment of intracranial aneurysms: a\u00a0retrospective data analysis of a\u00a0single center. Acta Neurochir (Wien). 2019;161:1165-73.","journal-title":"Acta Neurochir"},{"key":"846_CR15","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.wneu.2019.02.044","volume":"126","author":"RH Dossani","year":"2019","unstructured":"Dossani RH, Patra DP, Kosty J, Jumah F, Kuybu O, Mohammed N, Waqas M, Riaz M, Cuellar H. Early versus delayed flow diversion for ruptured Intracranial aneurysms: a meta-analysis. World Neurosurg. 2019;126:41\u201352.","journal-title":"World Neurosurg"},{"key":"846_CR16","doi-asserted-by":"publisher","first-page":"120","DOI":"10.3171\/2015.6.JNS151038","volume":"125","author":"W Brinjikji","year":"2016","unstructured":"Brinjikji W, Piano M, Fang S, Pero G, Kallmes DF, Quilici L, Valvassori L, Lozupone E, Cloft HJ, Boccardi E, Lanzino G. Treatment of ruptured complex and large\/giant ruptured cerebral aneurysms by acute coiling followed by staged flow diversion. J\u00a0Neurosurg. 2016;125:120\u20137.","journal-title":"J. Neurosurg."},{"key":"846_CR17","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1136\/neurintsurg-2017-013742","volume":"10","author":"JE Cohen","year":"2018","unstructured":"Cohen JE, Gomori JM, Leker RR, Spektor S, Abu El Hassan H, Itshayek E. Stent and flow diverter assisted treatment of acutely ruptured brain aneurysms. J\u00a0Neurointerv Surg. 2018;10:851\u20138.","journal-title":"J Neurointerv Surg"},{"key":"846_CR18","doi-asserted-by":"publisher","first-page":"386","DOI":"10.3171\/jns.1991.74.3.0386","volume":"74","author":"S Juvela","year":"1991","unstructured":"Juvela\u00a0S, Hillbom\u00a0M, Kaste\u00a0M. Platelet thromboxane release and delayed cerebral ischemia in patients with subarachnoid hemorrhage. J\u00a0Neurosurg. 1991;74:386\u201392.","journal-title":"J. Neurosurg."},{"key":"846_CR19","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1590\/S0103-507X2011000100015","volume":"23","author":"AF de Lucena","year":"2011","unstructured":"de Lucena\u00a0AF, Tib\u00farcio\u00a0RV, Vasconcelos\u00a0GC, Ximenes\u00a0JDA, Cristino Filho\u00a0G, da Gra\u00e7a\u00a0RV. Influence of acute brain injuries on gut motility. Rev Bras Ter Intensiva. 2011;23:96\u2013103.","journal-title":"Rev Bras Ter Intensiva"},{"key":"846_CR20","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1136\/neurintsurg-2013-011023","volume":"7","author":"I Oran","year":"2015","unstructured":"Oran\u00a0I, Cinar\u00a0C, Bozkaya\u00a0H, Korkmaz\u00a0M. Tailoring platelet inhibition according to multiple electrode aggregometry decreases the rate of thrombotic complications after intracranial flow-diverting stent implantation. J\u00a0Neurointerv Surg. 2015;7:357\u201362.","journal-title":"J Neurointerv Surg"},{"key":"846_CR21","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1007\/s12028-016-0292-4","volume":"26","author":"JA Frontera","year":"2017","unstructured":"Frontera JA, Provencio JJ, Sehba FA, McIntyre TM, Nowacki AS, Gordon E, Weimer JM, Aledort L. The role of platelet activation and inflammation in early brain injury following subarachnoid hemorrhage. Neurocrit Care. 2017;26:48\u201357.","journal-title":"Neurocrit Care"},{"key":"846_CR22","doi-asserted-by":"publisher","first-page":"1682","DOI":"10.3174\/ajnr.A4365","volume":"36","author":"C-W Ryu","year":"2015","unstructured":"Ryu CW, Park S, Shin HS, Koh JS. Complications in stent-assisted endovascular therapy of ruptured Intracranial aneurysms and relevance to antiplatelet administration: a systematic review. AJNR Am J Neuroradiol. 2015;36:1682\u20138.","journal-title":"AJNR Am J Neuroradiol"},{"key":"846_CR23","doi-asserted-by":"publisher","DOI":"10.29046\/JHNJ.013.2.005","author":"E Atallah","year":"2018","unstructured":"Atallah\u00a0E, Saad\u00a0H, Bekelis\u00a0K, El-Chalouhi\u00a0N, Tjoumakaris\u00a0S, Hasan\u00a0D, Eller G, Stidd D, Rosenwasser RH, Jabbour P. The use of prasugrel and ticagrelor in pipeline flow diversion. JHN Journal. 2018;13:Art. 5 https:\/\/doi.org\/10.29046\/JHNJ.013.2.005.","journal-title":"JHN Journal"},{"key":"846_CR24","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurad.2019.01.094","author":"S Soize","year":"2019","unstructured":"Soize S, Foussier C, Manceau PF, Litr\u00e9 CF, Backchine S, Gawlitza M, Pierot L. Comparison of two preventive dual antiplatelet regimens for unruptured intracranial aneurysm embolization with flow diverter\/disrupter: a matched-cohort study comparing clopidogrel with ticagrelor. J Neuroradiol. 2019;46:378-83.","journal-title":"J Neuroradiol"},{"key":"846_CR25","doi-asserted-by":"publisher","DOI":"10.1007\/s00062-019-00804-1","author":"I Oran","year":"2019","unstructured":"Oran\u00a0I, Cinar\u00a0C, Gok\u00a0M, Duzgun\u00a0F. Aggregometry response to half-dose prasugrel in\u00a0flow-diverting stent implantation. Clin Neuroradiol. 2019 Jun 4. doi: 10.1007\/s00062-019-00804-1. [Epub ahead of print]","journal-title":"Clin Neuroradiol"},{"key":"846_CR26","doi-asserted-by":"publisher","DOI":"10.1007\/s00062-019-00811-2","author":"L Abdennour","year":"2019","unstructured":"Abdennour L, Sourour N, Drir M, Premat K, Shotar E, Taylor G, Godier A, Mathout J, Lenck S, Bernard R, Carpentier A, Degos V, Claren\u00e7on F. Preliminary experience with cangrelor for endovascular treatment of challenging Intracranial aneurysms. Clin Neuroradiol. 2019 Jul 15. doi: 10.1007\/s00062-019-00811-2. [Epub ahead of print]","journal-title":"Clin Neuroradiol"},{"key":"846_CR27","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.wneu.2018.07.203","volume":"119","author":"CJ Griessenauer","year":"2018","unstructured":"Griessenauer\u00a0CJ, Goren\u00a0O, Dalal\u00a0SS, Schirmer\u00a0CM. Pipeline embolization device with shield technology for intracranial aneurysms: an initial U.S. experience. World Neurosurg. 2018;119:10-4.","journal-title":"World Neurosurg"},{"key":"846_CR28","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1186\/s41747-018-0084-z","volume":"3","author":"R Mart\u00ednez Moreno","year":"2019","unstructured":"Mart\u00ednez Moreno R, Bhogal P, Lenz-Habijan T, Bannewitz C, Siddiqui A, Lylyk P, Hannes R, Monstadt H, Henkes H. In vivo canine study of three different coatings applied to p64 flow-diverter stents: initial biocompatibility study. Eur Radiol Exp. 2019;3:3.","journal-title":"Eur Radiol Exp"},{"key":"846_CR29","doi-asserted-by":"publisher","first-page":"694","DOI":"10.1136\/neurintsurg-2018-014363","volume":"11","author":"NW Manning","year":"2019","unstructured":"Manning\u00a0NW, Cheung\u00a0A, Phillips\u00a0TJ, Wenderoth\u00a0JD. Pipeline shield with single antiplatelet therapy in aneurysmal subarachnoid haemorrhage: multicentre experience. J\u00a0Neurointerv Surg. 2019;11:694\u20138.","journal-title":"J Neurointerv Surg"}],"container-title":["Clinical Neuroradiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00062-019-00846-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00062-019-00846-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00062-019-00846-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T18:08:00Z","timestamp":1607623680000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s00062-019-00846-5"}},"subtitle":["A\u00a0Single Center Experience from 45\u00a0Consecutive Cases"],"short-title":[],"issued":{"date-parts":[[2019,11,4]]},"references-count":29,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["846"],"URL":"https:\/\/doi.org\/10.1007\/s00062-019-00846-5","relation":{},"ISSN":["1869-1439","1869-1447"],"issn-type":[{"value":"1869-1439","type":"print"},{"value":"1869-1447","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,4]]},"assertion":[{"value":"15 August 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 October 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 November 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical guidelines"}},{"value":"M.\u00a0AlMatter, V.\u00a0Hellstern, G.\u00a0Mitrovic, O.\u00a0Ganslandt and H.\u00a0B\u00e4zner declare that they have no competing interests. M. Aguilar P\u00e9rez has proctoring and consultancy agreements with Kaneka, Medtronic and phenox. H. Henkes is co-founder and shareholder of phenox.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The responsible ethics committee (Ethik-Kommission der Landes\u00e4rztekammer Baden-W\u00fcrttemberg) approved the retrospective collection, evaluation, and publication of the concerning data (Reference Nr. F\u20112016-128). Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}}]}}