37 Flow Diversion

Violiza Inoa, Nitin Goyal, Tarek Abuelem, and Adam S. Arthur

Abstract

This chapter is a review of flow diversion and its application in the treatment of intracranial aneurysms. We outline the development of this technique along with its advancements in concept and design over recent years. The reader will have the opportunity to review current indications of flow diversion and the safety and efficacy of this technique. We have included as “special considerations” some of the more challenging neurovascular conditions for which the use of flow diversion can be considered. Some of these uses have been extensively debated and remain off-label within the United States; however, we consider their inclusion relevant as we to aim to reflect accurately current clinical practice. This chapter would not be complete without a detailed description of the different devices that are currently available. We present the basic design, characteristics, individual advantages, and market availability of these devices. The unique features of each flow diverter and a brief technological update are included in table format. Additionally, we include images provided by their manufacturer that portray some of the devices. The chapter is concluded with the description of four clinical cases of flow diversion. The last case is presented in video format to best demonstrate the technique, angiographic appearance, and results of the case illustrated.

Key words

flow diversion - aneurysm - intracranial stent

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