Flow diverter device

What is a flow diverter device? 

A flow diverter device is used in a treatment known as flow diversion. Flow diversion is a minimally invasive treatment for unruptured aneurysms in the brain (intracranial aneurysms). An aneurysm is a bulging artery that occurs where the arterial wall is weak. The enlarged artery inflates in the weak area, and the walls can continue to weaken over time, increasing the risk of a rupture. An aneurysm can be likened to the inflation of a balloon. 

During flow diversion, the flow diverter device, which resembles a mesh cylinder, is placed inside the parent blood vessel to help divert blood flow away from the aneurysm. By doing so, this will prevent the aneurysm from expanding further and rupturing. In addition, this will help the aneurysm to close off overtime. This is necessary as a ruptured aneurysm is serious and can quickly become life-threatening, potentially resulting in conditions such as stroke. 

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Flow diversion. Image taken from here.

What should you expect during a flow diversion?

A flow diversion is usually carried out under general anesthesia. Under general anesthesia, you will be put into a sleep-like state, and you will not be able to move voluntarily or feel any pain. 

Following the procedure, you may feel a little pain and discomfort. Recovery time typically takes between a period of 6 weeks to 6 months. 

How risky is this treatment option? 

As flow diversion is a minimally invasive procedure, it is generally associated with low rates of morbidity and mortality [1]. In fact, studies show that flow diversion has an overall complication rate of 17.0 percent, a low mortality rate of 2.8 percent and a neurological morbidity rate of 4.5 percent [2]. 

Some complications which may arise during the procedure include: 

  • Vascular injuries (Injuries to surrounding blood vessels)
  • Infections
  • Transient Ischemic Attack (TIA). A TIA is a minor stroke that lasts only for a few minutes. It is caused by a temporary blockage of blood supply to part of the brain, and usually leaves little to no permanent damage on the brain.
  • Stroke. A stroke occurs when blood flow to the brain is interrupted, either because the arteries leading to your brain are blocked or burst. As a result, oxygen supply to the brain is cut off, causing brain damage as cells in part of your brain die. When this happens, bodily functions controlled by damaged parts of your brain are lost. 
  • Intracranial haemorrhage (bleeding in the brain)
  • Death

Despite its possible complications, research has shown that flow diversion is an effective treatment option for unruptured intracranial aneurysms, with a 74.9 percent chance of the aneurysm being completely closed off after the procedure [1]. 

What do I do after I get this treatment?

After the procedure has been completed, you will probably have to return to the clinic for a couple of check ups by your doctor. 

In addition, your doctor may conduct a follow up angiogram to make sure that the aneurysm has closed off. An angiogram is a medical imaging technique which helps your doctor to visualise the inside of specific blood vessels in your body.

If you have any other questions regarding this procedure, it is important to consult and seek medical advice from a doctor to clarify your doubts. 

References
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  1. Fiorella, D., Gache, L., Frame, D., & Arthur, A. S. (2020). How safe and effective are flow diverters for the treatment of unruptured small/medium intracranial aneurysms of the internal carotid artery? Meta-analysis for evidence-based performance goals. Journal of NeuroInterventional Surgery, 12(9), 869–873. https://doi.org/10.1136/neurintsurg-2019-015535 
  2. Alderazi, Y. J., Shastri, D., Kass-Hout, T., Prestigiacomo, C. J., & Gandhi, C. D. (2014, May 20). Flow Diverters for Intracranial Aneurysms. Stroke Research and Treatment. https://www.hindawi.com/journals/srt/2014/415653/ 
  3. Zhou, G., Su, M., Yin, Y.-L., & Li, M.-H. (2017). Complications associated with the use of flow-diverting devices for cerebral aneurysms: a systematic review and meta-analysis. Neurosurgical Focus, 42(6), E17. https://doi.org/10.3171/2017.3.focus16450 
  4. Kieffer, S. (2017, December 8). Flow Diversion with Stents for Aneurysms | Treatment | Johns Hopkins Aneurysm Center. Hopkinsmedicine.org. https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/aneurysm/treatment/flow-diversion.html
  5. Kim, S. O., Chung, Y. G., Won, Y. S., & Rho, M. H. (2016). Delayed Ischemic Stroke after Flow Diversion of Large Posterior Communicating Artery Aneurysm. Journal of Cerebrovascular and Endovascular Neurosurgery, 18(1), 19–26. https://doi.org/10.7461/jcen.2016.18.1.19