title: Flow-diversion panacea or poison?
abstract: Endovascular therapy is now the treatment of choice for intracranial aneurysms (IAs) for its efficacy and safety profile. The use of flow diversion (FD) has recently expanded to cover many types of IAs in various locations. Some institutions even attempt FD as first line treatment for unruptured IAs. The most widely used devices are the pipeline embolization device (PED), the SILK flow diverter (SFD), the flow redirection endoluminal device (FRED), and Surpass. Many questions were raised regarding the long-term complications, the optimal regimen of dual antiplatelet therapy, and the durability of treatment effect. We reviewed the literature to address these questions as well as other concerns on FD when treating IAs.
authors.affiliation: Department of Neurosurgery, Jefferson Hospital for Neuroscience, Thomas Jefferson University , Philadelphia , PA, USA.
authors.forename: Mario
authors.initials: M
authors.lastname: Zanaty
authors.affiliation: Department of Neurosurgery, Jefferson Hospital for Neuroscience, Thomas Jefferson University , Philadelphia , PA, USA.
authors.forename: Nohra
authors.initials: N
authors.lastname: Chalouhi
authors.affiliation: Department of Neurosurgery, Jefferson Hospital for Neuroscience, Thomas Jefferson University , Philadelphia , PA, USA.
authors.forename: Stavropoula I
authors.initials: SI
authors.lastname: Tjoumakaris
authors.affiliation: Department of Neurosurgery, Jefferson Hospital for Neuroscience, Thomas Jefferson University , Philadelphia , PA, USA.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Rosenwasser
authors.affiliation: Department of Neurosurgery, Jefferson Hospital for Neuroscience, Thomas Jefferson University , Philadelphia , PA, USA.
authors.forename: L Fernando
authors.initials: LF
authors.lastname: Gonzalez
authors.affiliation: Department of Neurosurgery, Jefferson Hospital for Neuroscience, Thomas Jefferson University , Philadelphia , PA, USA.
authors.forename: Pascal
authors.initials: P
authors.lastname: Jabbour
keywords: FRED; PED; Surpass; flow diversion; intracranial aneurysm; pipeline