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CNS & Neurological Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5273
ISSN (Online): 1996-3181

Mini-Review Article

Flow Diversion for the Management of Posterior Circulation’s Intracranial Aneurysms

Author(s): Antonis Adamou, Kirill Alektoroff, Maria Politi, Maria Alexandrou, Christian Roth and Panagiotis Papanagiotou*

Volume 23, Issue 11, 2024

Published on: 16 October, 2023

Page: [1297 - 1302] Pages: 6

DOI: 10.2174/1871527322666230626110934

Price: $65

Abstract

The endovascular treatment of posterior circulation aneurysms, although challenging, has been well-established due to various factors that limit the surgical approach in most cases. Flow diversion has also been utilized in the treatment of such aneurysms, although its effectiveness and safety still require evaluation. Numerous studies have examined the outcomes and complication rates in patients treated with FD, resulting in varying findings. This review aimed to summarize the most recent literature concerning the effectiveness of flow diversion devices in posterior circulation aneurysms. Additionally, it highlights reports that compare results in the posterior versus anterior circulation, as well as flow diversion versus stent-assisted coiling.

Graphical Abstract

[1]
Spetzler RF, McDougall CG, Zabramski JM, et al. The Barrow Ruptured Aneurysm Trial: 6-year results. J Neurosurg 2015; 123(3): 609-17.
[http://dx.doi.org/10.3171/2014.9.JNS141749] [PMID: 26115467]
[2]
Zhao J, Wang S, Yang L, Zhao Y. Clinical experience of 153 patients with posterior circulation aneurysms. J Clin Neurosci 2005; 12(1): 17-20.
[http://dx.doi.org/10.1016/j.jocn.2003.12.021] [PMID: 15639405]
[3]
International Study of Unruptured Intracranial Aneurysms Investigators. Unruptured intracranial aneurysms — risk of rupture and risks of surgical intervention. N Engl J Med 1998; 339(24): 1725-33.
[http://dx.doi.org/10.1056/NEJM199812103392401] [PMID: 9867550]
[4]
Shao B, Wang J, Chen Y, et al. Clipping versus Coiling for ruptured intracranial aneurysms: A meta-analysis of randomized controlled trials. World Neurosurg 2019; 127: e353-65.
[http://dx.doi.org/10.1016/j.wneu.2019.03.123] [PMID: 30928577]
[5]
Ahmed SI, Javed G, Bareeqa SB, et al. Endovascular coiling versus neurosurgical clipping for aneurysmal subarachnoid hemorrhage: A systematic review and meta-analysis. Cureus 2019; 11(3): e4320.
[6]
Nohra C, Stavropoula T, Starke RM, et al. Comparison of flow diversion and coiling in large unruptured intracranial saccular aneurysms. Stroke 2013; 44: 2150-4.
[http://dx.doi.org/10.1161/STROKEAHA.113.001785] [PMID: 23723311]
[7]
Brisman JL, Song JK, Newell DW. Cerebral Aneurysms. N Engl J Med 2006; 355(9): 928-39.
[http://dx.doi.org/10.1056/NEJMra052760] [PMID: 16943405]
[8]
Wang CB, Shi WW, Zhang GX, Lu HC, Ma J. Flow diverter treatment of posterior circulation aneurysms. A meta-analysis. Neuroradiology 2016; 58(4): 391-400.
[http://dx.doi.org/10.1007/s00234-016-1649-2] [PMID: 26801480]
[9]
Kallmes DF, Hanel R, Lopes D, et al. International retrospective study of the pipeline embolization device: A multicenter aneurysm treatment study. AJNR Am J Neuroradiol 2015; 36(1): 108-15.
[http://dx.doi.org/10.3174/ajnr.A4111] [PMID: 25355814]
[10]
Lopes DK, Jang DK, Cekirge S, et al. Morbidity and mortality in patients with posterior circulation aneurysms treated with the pipeline embolization device: A subgroup analysis of the international retrospective study of the pipeline embolization device. Neurosurgery 2018; 83(3): 488-500.
[http://dx.doi.org/10.1093/neuros/nyx467] [PMID: 28945879]
[11]
Cagnazzo F, di Carlo DT, Cappucci M, Lefevre PH, Costalat V, Perrini P. Acutely ruptured intracranial aneurysms treated with flow-diverter stents: A systematic review and meta-analysis. AJNR Am J Neuroradiol 2018; 39(9): 1669-75.
[http://dx.doi.org/10.3174/ajnr.A5730] [PMID: 30049721]
[12]
Cebral JR, Mut F, Raschi M, et al. Aneurysm rupture following treatment with flow-diverting stents: Computational hemodynamics analysis of treatment. AJNR Am J Neuroradiol 2011; 32(1): 27-33.
[http://dx.doi.org/10.3174/ajnr.A2398] [PMID: 21071533]
[13]
Cebral JR, Castro MA, Putman CM, Alperin N. Flow-area relationship in internal carotid and vertebral arteries. Physiol Meas 2008; 29(5): 585-94.
[http://dx.doi.org/10.1088/0967-3334/29/5/005] [PMID: 18460763]
[14]
Waleed B, Murad MH, Giuseppe L, Cloft HJ, Kallmes DF. Stroke 2013; 44: 442-7.
[http://dx.doi.org/10.1161/STROKEAHA.112.678151] [PMID: 23321438]
[15]
Wallace AN, Madaelil TP, Kamran M, et al. Pipeline embolization of vertebrobasilar aneurysms-a multicenter case series. World Neurosurg 2019; 124: e460-9.
[http://dx.doi.org/10.1016/j.wneu.2018.12.116] [PMID: 30610980]
[16]
Liang F, Zhang Y, Yan P, Ma C, Liang S, Jiang C. Outcomes and complications after the use of the pipeline embolization device in the treatment of intracranial aneurysms of the posterior circulation: A systematic review and meta-analysis. World Neurosurg 2019; 127: e888-95.
[http://dx.doi.org/10.1016/j.wneu.2019.03.291] [PMID: 30959253]
[17]
Zhou G, Su M, Yin YL, Li MH. Complications associated with the use of flow-diverting devices for cerebral aneurysms: A systematic review and meta-analysis. Neurosurg Focus 2017; 42(6): E17.
[http://dx.doi.org/10.3171/2017.3.FOCUS16450] [PMID: 28565981]
[18]
Wallace AN, CreveCoeur TS, Grossberg JA, et al. Impact of aneurysm morphology on safety and effectiveness of flow diverter treatment of vertebrobasilar aneurysms. J Neuroradiol 2019; 46: 401-10.
[http://dx.doi.org/10.1016/j.neurad.2019.02.003] [PMID: 30857898]
[19]
Liang F, Zhang Y, Yan P, et al. Predictors of periprocedural complications and angiographic outcomes of endovascular therapy for large and giant intracranial posterior circulation aneurysms. World Neurosurg 2019; 125: e378-84.
[http://dx.doi.org/10.1016/j.wneu.2019.01.080] [PMID: 30703589]
[20]
Kiselev R, Orlov K, Dubovoy A, et al. Flow diversion versus parent artery occlusion with bypass in the treatment of complex intracranial aneurysms: Immediate and short-term outcomes of the randomized trial. Clin Neurol Neurosurg 2018; 172: 183-9.
[http://dx.doi.org/10.1016/j.clineuro.2018.06.042] [PMID: 30053620]
[21]
Domingo RA, Tripathi S, Perez-Vega C, et al. Treatment of posterior circulation non-saccular aneurysms with flow diversion versus stent-assisted coiling: A systematic review and meta-analysis. J Neurointerv Surg 2021; 13(2): 159-63.
[http://dx.doi.org/10.1136/neurintsurg-2020-016294] [PMID: 32651184]
[22]
Girdhar G, Andersen A, Pangerl E, et al. Thrombogenicity assessment of Pipeline Flex, Pipeline Shield, and FRED flow diverters in an in vitro human blood physiological flow loop model. J Biomed Mater Res A 2018; 106(12): 3195-202.
[http://dx.doi.org/10.1002/jbm.a.36514] [PMID: 30242950]

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