This protocol addresses a specific subset of aneurysmal subarachnoid hemorrhage (aSAH) where the underlying aneurysm has a morphology that prevents standard surgical or endovascular repair — requiring a distinct management approach.
The clinical situation: aSAH caused by a ruptured wide-neck cerebral aneurysm whose geometry makes it unsuitable for surgical clipping or primary coiling. The aneurysm's configuration drives the treatment selection and raises the urgency of alternative intervention.
In this scenario, endovascular techniques play a central role — specifically approaches that provide structural support or redirect flow to achieve aneurysm occlusion. The complete protocol details the indications, procedural selection, and clinical considerations.
DOI: 10.1161/str.0000000000000436
For patients with aSAH from ruptured wide-neck aneurysms not amenable to surgical clipping or primary coiling, endovascular treatment with stent-assisted coiling or flow diverters is reasonable to reduce the risk of rebleed.
View source ↗