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Related Concept Videos

Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

425
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
425

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Related Experiment Video

Updated: Mar 12, 2026

Experimental Investigation of Secondary Flow Structures Downstream of a Model Type IV Stent Failure in a 180° Curved Artery Test Section
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A technical consideration when using flow diversion for recurrent aneurysms following stent-assisted coiling.

Justin R Mascitelli1, Daniel Wei1, Thomas J Oxley1

  • 1Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

BMJ Case Reports
|November 18, 2016
PubMed
Summary

Flow diversion (FD) placement after stent-assisted coiling (SAC) can be challenging. A novel technique using an intermediate catheter ensures microwire stability within the stent, preventing complications.

Keywords:
AneurysmFlow DiverterStentTechnique

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Area of Science:

  • Endovascular neurosurgery
  • Cerebrovascular disease management
  • Medical device innovation

Background:

  • Flow diversion (FD) is an emerging treatment for recurrent aneurysms, particularly after stent-assisted coiling (SAC).
  • Technical difficulties in FD placement over prior stents can compromise treatment efficacy and safety.
  • Potential complications include microwire entanglement or deviation from the stent's central axis.

Observation:

  • A case report details a modified technique for FD placement following SAC.
  • The modification involves advancing an intermediate catheter completely through the existing stent.
  • This maneuver ensures the microwire remains within the central axis of the stent.

Findings:

  • The intermediate catheter's larger diameter prevents the microwire from deviating ('in-out-in') from the stent.
  • Successful FD deployment was achieved using this technique.
  • The method facilitates complete FD opening and may mitigate thromboembolic risks.

Implications:

  • This technique offers a potential solution to a recognized challenge in endovascular aneurysm treatment.
  • It may improve the safety and effectiveness of flow diversion in complex cases.
  • Further studies are warranted to validate this approach in a broader patient population.