Flow diversion for intracranial aneurysms: a review

Area of Science:

• Neuroendovascular surgery
• Cerebrovascular disease treatment
• Medical device innovation

Background:

• Intracranial aneurysms pose significant risks, necessitating advanced treatment options.
• Flow diverters represent a paradigm shift, targeting the diseased vessel segment rather than the aneurysm directly.
• These devices aim to disrupt flow, promoting thrombosis and aneurysm sac remodeling.

Purpose of the Study:

• To evaluate the efficacy and safety of flow diverters in treating intracranial aneurysms.
• To highlight the mechanism of action of flow diverters in promoting aneurysm occlusion.
• To identify remaining questions regarding flow diverter therapy.

Main Methods:

• Review of preliminary clinical series on flow diverter application.
• Analysis of the theoretical principles behind flow diversion.
• Assessment of reported outcomes including complication rates.

Main Results:

• Flow diverters demonstrate effectiveness in treating wide-neck, large, and giant intracranial aneurysms.
• Acceptable complication rates have been reported in initial studies.
• The mechanism involves intra-aneurysmal thrombosis and subsequent sac shrinkage.

Conclusions:

• Flow diverters offer a promising treatment for complex intracranial aneurysms.
• Further investigation is required concerning aneurysm rupture incidence, perforator vessel fate, and long-term patency.
• Long-term outcomes and safety profiles require continued monitoring.