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Review
. 2016 Jan 28;8(1):e472.
doi: 10.7759/cureus.472.

The Use of Flow Diversion for the Treatment of Intracranial Aneurysms: Expansion of Indications

Adam M Brouillard  1 , Xingwen Sun  2 , Adnan H Siddiqui  1 , Ning Lin  3
Affiliations
Review

The Use of Flow Diversion for the Treatment of Intracranial Aneurysms: Expansion of Indications

Adam M Brouillard et al. Cureus. .

Abstract

Flow diversion is a novel concept for treating anatomically challenging intracranial aneurysms and has gained increasing acceptance. Flow diverter stents, such as the Pipeline Embolization Device (PED) (ev3-Covidien, Irvine, CA, USA), are approved for treating unruptured large and giant aneurysms from the internal carotid artery between the superior hypophyseal and cavernous segments. However, technological advances and recent clinical results suggest that flow diversion can be safely and effectively used in treating ruptured aneurysms, posterior circulation aneurysms, and distal anterior circulation aneurysms. In this brief review, we aim to investigate the recent evidence on the utilization of PEDs in these controversial vascular territories and to discuss whether the indications for flow diversion can be expanded.

Keywords: coil embolization; complication; endovascular treatment; flow diversion; intracranial aneurysm; ruptured aneurysm.

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Conflict of interest statement

Disclosures: All authors have seen and approved this manuscript. The work has not been published elsewhere. Dr. Siddiqui reports the following relationships Research grants: The National Institutes of Health (co-investigator: NINDS 1R01NS064592-01A1, Hemodynamic induction of pathologic remodeling leading to intracranial aneurysms), The National Institutes of Health (co-investigator: NIBIB 5 R01 EB002873-07, Micro-Radiographic Image for Neurovascular Interventions), The National Institutes of Health (co-investigator: NIH/NINDS 1R01NS091075 Virtual Intervention of Intracranial Aneurysms); Financial interests: Hotspur, Intratech Medical, StimSox, Valor Medical, Blockade Medical, Lazarus Effect, Pulsar Vascular, Medina Medical; Consultant: Codman & Shurtleff, Covidien Vascular Therapies, GuidePoint Global Consulting, Penumbra, Stryker, Pulsar Vascular, MicroVention, Lazarus Effect, Blockade Medical, Reverse Medical, W.L. Gore & Associates; National Steering Committees:Penumbra-3D Separator Trial, Covidien-SWIFT PRIME Trial, MicroVention-FRED Trial; Speakers’ bureau: Codman & Shurtleff, Inc.; Advisory Board: Codman & Shurtleff, Covidien Neurovascular, ICAVL, Medina Medical; Honoraria: Penumbra, Toshiba Medical Systems.

References

    1. Definitive reconstruction of circumferential, fusiform intracranial aneurysms with the pipeline embolization device. Fiorella D, Woo HH, Albuquerque FC, Nelson PK. Neurosurgery. 2008;62:1115–1120. - PubMed
    1. Curative reconstruction of a giant midbasilar trunk aneurysm with the pipeline embolization device. Fiorella D, Kelly ME, Albuquerque FC, Nelson PK. Neurosurgery. 2009;64:212–217. - PubMed
    1. Curative cerebrovascular reconstruction with the Pipeline embolization device: the emergence of definitive endovascular therapy for intracranial aneurysms. Fiorella D, Lylyk P, Szikora I, Kelly ME, Albuquerque FC, McDougall CG, Nelson PK. J Neurointerv Surg. 2009;1:56–65. - PubMed
    1. Pipeline embolization device (PED) for neurovascular reconstruction: initial experience in the treatment of 101 intracranial aneurysms and dissections. Fischer S, Vajda Z, Aguilar Perez M, Schmid E, Hopf N, Bäzner H, Henkes H. Neuroradiology. 2012;54:369–382. - PMC - PubMed
    1. Flow-diverter stent for the endovascular treatment of intracranial aneurysms: a prospective study in 29 patients with 34 aneurysms. Lubicz B, Collignon L, Raphaeli G, Pruvo JP, Bruneau M, De Witte O, Leclerc X. Stroke. 2010;41:2247–2253. - PubMed