Flow Diversion for the Treatment of Intracranial Aneurysms.
OBJECTIVE
Brain aneurysms have traditionally been treated with surgical clipping or endovascular coiling techniques. With these modalities, many large or complex aneurysms remain difficult to treat. A new option, flow diversion, is now available to treat aneurysms.


OBJECTIVE
To summarize the clinical progression of flow diversion technology, from an experimental treatment to a commonly used method to treat large or complex aneurysms.


METHODS
References for this topical review were identified by searches of PubMed and GoogleScholar between January 2000 and January 2016. The search terms aneurysm, flow diverter, stent, pipeline, FRED, SURPASS, SILK, flow diversion, and endovascular were used. Ongoing clinical trials were identified using the same search terms in the clinicaltrial.gov registry. Attention was focused on current indications, rates of complications, and areas of ongoing study in randomized clinical trials.


RESULTS
Flow diversion is a treatment approved by the US Food and Drug Administration for brain aneurysms that redirects blood flow away from the aneurysm, thereby promoting growth of a new endothelial lining across the aneurysm opening. Cure rates with this technology are high and complication rates are low.


CONCLUSIONS
Flow diversion is a disruptive technology that has changed the way many brain aneurysms are treated. It is currently a preferred treatment option for large or giant wide-necked proximal internal carotid artery aneurysms. Ongoing randomized studies will help to more rigorously determine the efficacy of flow diversion.
Department of Neurological Surgery, University of California, San Francisco.
Brian P
BP
Walcott
Department of Neurological Surgery, Massachusetts General Hospital & Harvard Medical School, Boston.
Christopher J
CJ
Stapleton
Department of Neurological Surgery, University of California, San Francisco.
Omar
O
Choudhri
Department of Neurological Surgery, Massachusetts General Hospital & Harvard Medical School, Boston.
Aman B
AB
Patel
D002560:Cerebrovascular Circulation / Q000502:physiology*; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D019635:Neurosurgical Procedures / Q000379:methods; D015607:Stents; D016896:Treatment Outcome