UNASSIGNED: OBJECT Flow-diversion treatment has been shown to be associated with high rates of angiographic obliteration; however, the treatment is relatively contraindicated in the acute phase following @entity510 ( @entity510 ) as these @entity1 require periprocedural dual antiplatelet therapy. Acute coiling followed by flow diversion has emerged as an intriguing and feasible treatment option for ruptured complex and @entity439 . In this study the authors report outcomes and complications of @entity1 with @entity1756 undergoing coiling in the acute phase followed by planned delayed flow diversion. METHODS This case series includes @entity1 from 2 institutions. All @entity1 underwent standard endovascular coiling in the acute phase after @entity510 with the intention and plan to proceed with flow diversion at a later date. Outcomes studied included angiographic occlusion, procedure-related complications, and long-term clinical outcome as measured using the modified Rankin Scale. RESULTS A total of 31 @entity1 underwent coiling in the acute phase with the intention to undergo flow diversion at a later date. The mean @entity439 size was 15.8    7.9 mm. Of the 31 @entity1 undergoing coiling, 4 @entity1 could not undergo further flow-diverter therapy: 3 @entity1 (9.7%) died of complications of @entity510 and 1 @entity1 had permanent morbidity as a result of perioperative @entity385 (3.1%). Twenty-seven @entity1 underwent staged placement of flow diverters after adequate recovery. The median time to treatment was 16 weeks. There was one case of @entity439 rebleeding following coil treatment. There were no cases of permanent morbidity or mortality resulting from flow-diverter treatment. Twenty-four @entity1 underwent imaging follow-up; 18 of these @entity1 had @entity439 that were completely or nearly completely occluded (58.1% on an intent-to-treat basis). At last follow-up (mean 18.3 months), 25 @entity1 had mRS scores  <= 2 (80.6% on an intent-to-treat basis). CONCLUSIONS Staged treatment of ruptured complex and @entity438 with coiling in the acute phase and flow-diverter treatment following recovery from @entity510 is both safe and effective. In this series, no cases of rebleeding occurred during the interval between coiling and flow diversion. This strategy should be considered as a valid option in @entity1 presenting with these challenging @entity1756 .

Treatment of ruptured complex and large/giant ruptured XXXX by acute coiling followed by staged flow diversion.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity510 :: ('MESH:D013345', 'Disease') :: ['SAH', 'subarachnoid hemorrhage'] @entity1756 :: ('MESH:D017542', 'Disease') :: ['ruptured aneurysms'] @entity438 :: ('MESH:D002532', 'Disease') :: ['giant intracranial aneurysms'] @entity439 :: ('MESH:D000783', 'Disease') :: ['aneurysms', 'giant aneurysms', 'aneurysm'] @entity385 :: ('MESH:D002544', 'Disease') :: ['ischemic stroke']
@entity438 :: (MESH:D002532,Disease) :: ['cerebral aneurysms']
