What is flow diversion?

Flow Diversion is an Endovascular Technique to divert the blood flow away from the aneurysm. Instead of inserting a device inside the aneurysm sac, as with coiling, a device is placed in the parent blood artery to divert blood flow away from the aneurysm. An unruptured brain aneurysm may be treated using a flow diversion technique. Flow diversion is one way for avoiding the riskiest phase of endovascular aneurysm treatment which is entering the aneurysm. By not putting a device into the aneurysm, the chance of it rupturing during surgery is considerably reduced.

How Does the Flow Diversion Work?

For the procedure, the doctors use:

1. Use modern imaging technologies and radioactive contrast dye to observe your blood arteries clearly.
2. Pass a catheter through your blood vessels until it reaches the aneurysm’s location.
3. Place a stent, a small, clever device, in the parent blood vessel of the aneurysm, where the aneurysm is developed, with care. This redirects blood flow away from the aneurysm, ensuring that it is no longer a threat to your health.

Flow Diversion and Mechanism of Action

Flow diverters are stent-like devices that are used to treat aneurysms endovascularly. Flow diverters, rather than endosaccular filling, allow endoluminal (area inside the blood vessel) rebuilding. To promote aneurysm thrombosis, flow diverters affect the parent artery/aneurysm sac interface, such as by changing in-flow and out-flow jets. After the device is implanted, intrasaccular thrombosis develops. The stent is then covered by neointimal (scar tissue that forms within the blood vessel) overgrowth, which reconstructs the parent artery and eliminates the aneurysm/parent vascular interface. The origins of perforators are usually spared throughout this procedure.

Furthermore, when these procedures are utilized to repair fusiform aneurysms (Fusiform Aneurysms are the non-saccular dilatation that involves the entire vessel), they allow for the rebuilding of a smooth endothelial-covered channel that runs parallel to the parent artery. These characteristics are expected to contribute to a long-term reduction in rupture rates. The aneurysm shrinks and collapses around the device construct over time, reducing mass effect symptoms. Temporary perianeurysmal oedema in surrounding brain tissue may accompany the aneurysm’s thrombosis and accompanying inflammation. In order to achieve endoluminal reconstruction and aneurysm obliteration, flow diverters take advantage of hemodynamics, thrombosis, inflammation, healing, and endothelial regeneration.

Flow diverter procedures, unlike coil embolization, cause aneurysms to occlude over time rather than immediately at the end of the surgery. This explains why aneurysm occlusion rates with flow diverters continue to rise after 6 to 12 months.

The Advantages of Flow Diversion for Aneurysms

At ABC, the flow diversion approach is frequently used to treat aneurysms. The following are some of the advantages:

• Enhanced security: This kind of treatment avoids the need for doctors to penetrate the aneurysm itself, which is often the most dangerous element of an endovascular procedure.
• Many patients who previously needed extensive surgery can now get this technique and return home the next day. Within a week, some patients are able to return to work.
• Less recurrence: This method appears to have lowered the rate of recurrence (the chance a patient will develop another aneurysm).
• Less radiation exposure: Compared to other endovascular methods, this operation exposes patients to far less radiation.
• Lower costs: Compared to other endovascular treatment options, this operation is less expensive.

Conclusions

Flow diverters offer a substantial paradigm shift in cerebral aneurysm endovascular treatment. These devices allow for neointima formation while diverting flow away from the aneurysm into the parent vessel, allowing for regeneration of the damaged segment. Aneurysm thrombosis occurs, followed by aneurysm shrinkage when the clot organizes and retracts. Early clinical experiences have been encouraging, with high rates of total aneurysm closure after thorough in vitro and in vivo trials.

However, there are worries about the devices’ side effects, which are mostly related to aneurysm rupture during the latency period and thromboembolic consequences. Furthermore, there are still unanswered problems about what happens to small crucial perforators after they are covered with flow diverters. To resolve some of these unresolved difficulties, careful investigation and follow-up of treated patients are required. Reach us out at ABC’s Customer Care number for expert advice and follow-ups.