Flow Diversion for Endovascular Treatment of Intracranial Aneurysms: Past, Present, and Future Directions

Overview

Journal J Clin Med

Specialty General Medicine

Date 2024 Jul 27

PMID 39064207

Authors

Michael Gaub

Greg Murtha

Molly Lafuente

Matthew Webb

Anqi Luo

Lee A Birnbaum

Justin R Mascitelli

Fadi Al Saiegh

Affiliations

Soon will be listed here.

Abstract

Flow diversion for intracranial aneurysms emerged as an efficacious and durable treatment option over the last two decades. In a paradigm shift from intrasaccular aneurysm embolization to parent vessel remodeling as the mechanism of action, the proliferation of flow-diverting devices has enabled the treatment of many aneurysms previously considered untreatable. In this review, we review the history and development of flow diverters, highlight the pivotal clinical trials leading to their regulatory approval, review current devices including endoluminal and intrasaccular flow diverters, and discuss current and expanding indications for their use. Areas of clinical equipoise, including ruptured aneurysms and wide-neck bifurcation aneurysms, are summarized with a focus on flow diverters for these pathologies. Finally, we discuss future directions in flow diversion technology including bioresorbable flow diverters, transcriptomics and radiogenomics, and machine learning and artificial intelligence.

Citing Articles

Treatment of unruptured intracranial vertebral artery dissection aneurysms with Flow Diverter compared with conventional stent-assisted coiling-a single-center study.

Zhang T, Zhong W, Zhou D, Xu Y, Li M, Zhuang J Acta Neurochir (Wien). 2024; 166(1):506.

PMID: 39690339 PMC: 11652399. DOI: 10.1007/s00701-024-06398-z.

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