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Case Reports
. 2013 Jan;34(1):E1-4.
doi: 10.3174/ajnr.A2613. Epub 2011 Aug 18.

A flow-diverting stent is not a pressure-diverting stent

J J Schneiders  1 , E VanBavel, C B Majoie, S P Ferns, R van den Berg
Affiliations
Case Reports

A flow-diverting stent is not a pressure-diverting stent

J J Schneiders et al. AJNR Am J Neuroradiol. 2013 Jan.

Abstract

The approach for treatment of large and fusiform intracranial aneurysms has evolved from stent-assisted coiling to treatment with flow-diverting stents. The treatment results for these stents are promising; however, early postprocedural aneurysm rupture has been described. The exact cause of rupture is unknown but might be related to intra-aneurysmal flow and pressure changes. We measured intra-aneurysmal pressure before, during, and after placement of a flow-diverting stent by using a dual-sensor guidewire. The pressure inside the aneurysm momentarily decreased during placement but was restored to baseline values within minutes. The flow-diverting stent does not seem to protect the aneurysm from the stress induced by pressure or pressure changes within the lumen.

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Figures

Fig 1.
Fig 1.
Conventional angiogram (A) and digital subtraction angiogram (B) show the Silk stent deployed in the MCA, and the jailed microcatheter with the ComboWire within the aneurysm. C, Schematic representation of the considered flows (arrows) and aneurysm compliance (arrowheads). X represents the jailed microcatheter containing the dual-sensor guidewire.
Fig 2.
Fig 2.
Systemic and intra-aneurysmal pressure measurements during stent deployment. A, Mean pressure. B, Peak systolic pressure. C, Pulse pressure.
See this image and copyright information in PMC

Comment in

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