Should stents be used in the treatment of ruptured intracranial aneurysms?

The indications for endovascular coiling of intracranial aneurysms continue to expand. This is due, in part, to the development of intracranial specific stents which permit remodelling of complex aneurysm necks. While this approach has several advantages in the setting of unruptured aneurysms, certain challenges, in particular the requirement of concomitant antiplatelet medication, may limit its use in treatment of ruptured intracranial aneurysms. These devices can be used safely and effectively in the treatment of selected ruptured aneurysms. One must weigh the potential hemorrhagic complications against the benefits of stent assisted coiling and the disadvantages of alternative approaches.