Update on flow diverters for the endovascular management of cerebral aneurysms

Abstract

Flow diversion has become a well-accepted option for the treatment of cerebral aneurysms. Given the significant treatment effect of flow diverters, numerous options have emerged since the initial Pipeline embolization device studies. In this review, the authors describe the available flow diverters, both endoluminal and intrasaccular, addressing nuances of device design and function and presenting data on complications and outcomes, where available. They also discuss possible future directions of flow diversion.

Keywords: AES = aneurysm embolization system; AP = anteroposterior; ASPIRe = Aneurysm Study of Pipeline in an Observational Registry; FRED; FRED = flow redirection endoluminal device; GpIIb/IIIa = glycoprotein IIb/IIIa; ICA = internal carotid artery; ID = inner diameter; IntrePED = International Retrospective Study of Pipeline Embolization Device; LUNA AES; LVIS = low-profile visualized intraluminal; MCA = middle cerebral artery; Medina; PED = Pipeline embolization device; PITA = The Pipeline Embolization Device for the Intracranial Treatment of Aneurysms; PUFS = Pipeline for Uncoilable or Failed Aneurysms; Pipeline embolization device; RADAR = Retrospective Analysis of Delayed Aneurysm Ruptures after Flow Diversion; SILK flow diverter; Surpass flow diverter; VA = vertebral artery; WEB; WEB = Woven EndoBridge; WEBCAST = WEB Clinical Assessment of Intrasaccular Aneurysm Therapy; flow diversion; intracranial aneurysm; p64.