Abstract
Treatment of intracranial aneurysms with complex morphology such as giant wide-necked or fusiform aneurysms is challenging. Stent-assisted coiling and balloon-assisted coiling are alternative treatment techniques, but studies have shown less than expected efficacy given their high rate of recanalization. Over the past few years, endoluminal techniques and flow-diverting devices (FDDs) have revolutionized the treatment of such complex aneurysms, for which the natural history of microsurgical or conventional neuroendovascular management has traditionally been poor. FDDs are implanted within the parent artery rather than the aneurysm sac. By modifying intra-aneurysmal and parent-vessel flow dynamics at the aneurysm/parent vessel interface, flow diversion triggers a cascade of gradual intra-aneurysmal thrombosis. As endothelialization of the FDD progresses, the parent vessel reconstructs while preserving the patency of normal perforators and side branch vessels. Herein we review FDDs, mechanisms of actions, current data and technical updates, complications and their management, and ongoing studies in relevance to the practicing neurointerventionalist.
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26 September 2021
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Cohen, E.R., Al-Mufti, F., Gupta, G., Roychowdhury, S. (2021). Endoluminal Approaches to Intracranial Aneurysms. In: Al-Mufti, MD, F., Amuluru MD, K. (eds) Cerebrovascular Disorders. Neuromethods, vol 170. Humana, New York, NY. https://doi.org/10.1007/978-1-0716-1530-0_6
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