This paper describes 12 patients with aneurysmal subarachnoid hemorrhage treated with cellulose acetate polymer (CAP) delivered intra-aneurysmally, to prevent early rebleeding, and then with tissue plasminogen activator (tPA) delivered via spinal catheter to lyse and draw off the subarachnoid clot. All the patients were Grade 3 to 5. Seven incomplete thrombotic aneurysms underwent direct clipping 2 to 7 weeks after CAP thrombosis, when intracranial pressure was normal, subarachnoid blood had cleared and the patients was presumably a more favorable clinical grade. There was no rebleeding and no severe symptomatic vasospasm in this treatment. The overall outcomes were satisfactory (including good in 8, disabled in 2, dead in 2).
