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KMID : 1005420150170010054
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Journal of Cerebrovascular and Endovascular Neurosurgery
2015 Volume.17 No. 1 p.54 ~ p.58
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Ventriculoperitoneal Shunt in a Patient with Ruptured Blister Aneurysm Treated with Pipeline Embolization Device
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Tan Lee A.
Gerard Carter S.
Keigher Kiffon M.
Moftakhar Moftakhar
Lopes Demetrius K.
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Abstract
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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.
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KEYWORD
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Ventriculoperitoneal shunt, Stents, Intracranial aneurysm, Subarachnoid hemorrhage
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