• Anshu Mahajan, Biplab Das, Karanjit Singh Narang, Jha Ajaya Nand AN Department of Neurosurgery, Institute of Neuroscience, Medanta The Medicity, Gurgaon, Haryana, India., Singh Varindera Paul VP Department of Neurosurgery, Institute of Neuroscience, Medanta The Medicity, Gurgaon, Haryana, India., Harsh Sapra, and Gaurav Goel.
• Department of Neurointerventional surgery, Institute of Neuroscience, Medanta The Medicity, Gurgaon, Haryana, India.
• World Neurosurg. 2018 Dec 1; 120: e1061-e1070.

BackgroundUse of a Surpass flow diverter (FD) device in the treatment of acutely ruptured aneurysm has not been well studied and reported in the literature.MethodsWe retrospectively reviewed patients with subarachnoid hemorrhage who were treated by Surpass FD placement at our hospital between June 2016 and March 2018. Detailed analysis of medical records was performed to obtain patient age, gender, clinical history, Hunt and Hess grade, Fisher grade, results of radiographic and procedural details including technical success and complication, clinical outcome, and follow-up angiographic results.ResultsOur search identified 16 patients with 16 aneurysms who were treated with Surpass FD, of which 13 aneurysms (81%) were in the anterior circulation and 3 (19%) were in the posterior circulation. Aneurysm size ranged from 1.1 to 16 mm, with a mean of 4 mm. The mean delay between subarachnoid hemorrhage and endovascular treatment was 5 days (range, 3-20 days). Only 1 Surpass FD was used in each patient, ranging in size from 3 × 25 mm to 4 × 50 mm. Fifteen patients (94%) achieved favorable clinical outcome (modified Rankin Scale score 0-1) at 3 months. One patient died of invasive fungal infection. Angiographic follow-up results were assessed by O'Kelly-Marotta grading scale in 15 surviving patients and showed a grade D result (no filling) in 13/15 aneurysms (87%) at 3 and 6 months.ConclusionsA Surpass FD device is a feasible option for the treatment of ruptured intracranial aneurysms that are difficult to treat by conventional clipping and coiling; however, larger and comparative studies with long-term follow-up are needed to confirm its safety and efficacy.Copyright © 2018 Elsevier Inc. All rights reserved.

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