The Expanding Realm of Endovascular Neurosurgery: Flow Diversion for Cerebral Aneurysm Management

Safety and efficacy of microsurgical treatment of previously coiled aneurysms: a systematic review and meta-analysis

“…For example, in our study, we found that surgical retreatment of aneurysms in the posterior circulation resulted in high rates of poor clinical outcome; meanwhile, it is generally accepted that endovascular coiling of posterior circulation aneurysms is safer than surgical clipping [24]. In addition, with the advent of newer endovascular techniques such as intraluminal flow diverters, endovascular therapy of these types of aneurysms could result in definitive treatment with low associated complication rates [4,20,38].…”

Cerebral aneurysm treatment: modern neurovascular techniques

“…When research studies demonstrated that denser coil packing with less coil prolapse into the parent vessel correlated with improved clinical and radiographic outcomes, fluid dynamic analysis revealed that endovascular stents actually accelerated aneurysmal thrombosis and alteration in blood flow into the aneurysm from the parent vessel 913 14 Flow diversion is fundamentally based on two concepts illustrated in figure 1: (1) the placement of a high-mesh density stent in the parent vessel disrupts blood flow into the aneurysm and (2) the stent provides a scaffold for which endothelium can grow, subsequently isolating the aneurysm from the parent circulation 15. Flow diversion thus allows for progressive intra-aneurysmal thrombosis over time with subsequent radiographic obliteration of the aneurysm.…”

Treatment of iatrogenic V2 segment vertebral artery pseudoaneurysm using Pipeline flow-diverting stent

“…[1] With the advent of coil embolization, balloon-assisted coil embolization, and flow-diverting stents, treatment of VA pseudoaneurysms has shifted toward these minimally invasive endovascular techniques. [6]…”

“…In addition, the mesh provides a scaffold for the subsequent endothelialization of the aneurysm neck, ultimately aiding in the isolation and obliteration of the aneurysm. [36] These flow-diverting stents have been investigated in the context of cerebral aneurysms, most commonly those stemming from the internal carotid artery (ICA). [3] Thus far, the use of flow-diverting stents for the treatment of ICA aneurysms has been promising, yielding low complication rates and high rates of complete angiographic occlusion of the aneurysm at 6-month follow-up.…”

“…[3] Thus far, the use of flow-diverting stents for the treatment of ICA aneurysms has been promising, yielding low complication rates and high rates of complete angiographic occlusion of the aneurysm at 6-month follow-up. [36] However, the use of flow-diverting stents for the treatment of pseudoaneurysms arising from the VAs, specifically the V3 segment, have only recently been described. [15] Here, we present a case of successful treatment of an iatrogenic pseudoaneurysm within the V2 segment using a flow-diverting stent.…”