LAUSR

To the Editor: We appreciate Dr. Brasiliense et al’s comments1 regarding our publication2 and sympathize with their group in regard to their very similar case. This is certainly a challenging subset of patients with historically high complication rates regardless of treatment modality. Despite these 2 instances, flow diversion may still prove to be a viable option. It appears that intraprocedural complications are relatively low compared with other treatment modalities, but it will remain to be seen whether there are increased rates of rerupture in the short or long term given the oftendelayed nature of aneurysm occlusion. Additionally, whether or not a single device is sufficient or if overlapping devices lead to better outcomes is also unsettled. As it remains, ruptured blister aneurysms are still a very challenging entity requiring a multidisciplinary focus between open cerebrovascular and endovascular neurosurgeons to ensure the best outcomes for these patients. These cases also illustrate the importance of counseling patients and families on the off-label use and potential complications of flow diversion. Disclosures