Flow diversion (FD) is a novel endovascular technique based on the profound alteration of cerebrovascular hemodynamics, which emerged as a promising minimally invasive therapy for intracranial aneurysms. However, delayed post-procedural stroke remains an unexplained concern. A consistent follow-up-regimen has not yet been defined, but is required urgently to clarify the underlying cause of delayed ischemia. In the last two years, 223 patients were treated with six different FD devices in our center. We identified subacute, FD-induced segmental vasospasm (SV) in 36 patients as a yet unknown, delayed-type reaction potentially compromising brain perfusion to a critical level. Furthermore, 86% of all patients revealed significant SV approximately four weeks after treatment. In addition, 56% had SV with 25% stenosis, and 80% had additional neointimal hyperplasia. Only 13% exhibited SV-related high-grade stenosis. One of those suffered stroke due to prolonged SV, requiring neurocritical care and repeated intra-arterial (i.a.) biochemical angioplasty for seven days to prevent territorial infarction. Five patients suffered newly manifested, transient hemicrania accompanying a compensatorily increased ipsilateral leptomeningeal perfusion. One treated vessel obliterated permanently. Hence, FD-induced SV is a frequent vascular reaction after FD treatment, potentially causing symptomatic ischemia or even stroke, approximately one month post procedure. A specifically early follow-up-strategy must be applied to identify patients at risk for ischemia, requiring intensified monitoring and potentially anti-vasospastic treatment.

Medium manganese steels can exhibit both high strength and ductility due to transformation-induced plasticity (TRIP), caused by metastable retained austenite, which in turn can be adjusted by intercritical annealing. This study addresses the laser additive processability and mechanical properties of the third-generation advanced high strength steels (AHSS) on the basis of medium manganese steel using Laser Powder Bed Fusion (LPBF). For the investigations, an alloy with a manganese concentration of 5 wt.% was gas atomized and processed by LPBF. Intercritical annealing was subsequently performed at different temperatures (630 and 770 °C) and three annealing times (3, 10 and 60 min) to adjust the stability of the retained austenite. Higher annealing temperatures lead to lower yield strength but an increase in tensile strength due to a stronger work-hardening. The maximum elongation at fracture was approximately in the middle of the examined temperature field. The microstructure and properties of the alloy were further investigated by scanning electron microscopy (SEM), hardness measurements, X-ray diffraction (XRD), electron backscatter diffraction (EBSD) and element mapping.

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