P069 Unusual management of 2 cases of MCA dissecting aneurysms

<h3>Introduction</h3> We present 2 cases of subarachnoid hemorrhage (SAH) due to the rupture of a middle cerebral artery (MCA) dissecting aneurysms treated with multiple Flow-Diverter Devices (FDDs). <h3>Case Description</h3> A 63 yo male symptomatic for SAH and an intraparenchymal hematoma due to a left MCA perforator dissecting aneurysm, treated with 3 overlapped FDDs. Because of systemic clinical conditions, he did not receive any antiplatelet drugs. CT-angio and DSA follow-up showed the patency of MCA and no rebleeding. A 46 yo female experienced a SAH due to a right perforator MCA aneurysm. The plan was to put an external ventricular drainage and then a FDD. Due to the worsening of clinical conditions, a surgical clipping was done. The post-clipping DSA showed the persistence of the aneurysm and it was treated by 2 overlapped FDDs. <h3>Results</h3> The acute treatment of dissecting perforator aneurysm using FDDs is feasable and safe, even in complex managements.