Branch vessel occlusion in aneurysm treatment with flow diverter stent

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Sophia Hohenstatt
Antonio Arrichiello
Giorgio Conte
Giuseppe Craparo
Ferdinando Caranci
Alessio Angileri
Daniel Levi
Gianpaolo Carrafiello
Aldo Paolucci

Keywords

aneurysm, branch vessel, patency, Side branches occlusion, flow diversion, flow diverter stent

Abstract

Flow diverter placement for treatment of intracranial aneurysms gained growing consensus in the past years. A major concern among professionals is the side branch coverage which leads in some cases to vessel occlusion. However, the lost vessel patency only infrequently is accompanied by a new onset of neurological deficits secondary to ischaemic lesions. A retrospective analysis of all patients treated with flow diversion at our hospital was aimed to better understand this phenomenon in order to formulate a hypothesis about the causes. We concluded that vessel occlusion occurs due to a reduced blood pressure gradient in those vessels with a strong collateral or anastomotic vascularization that refurnishes the same distal vascular territories. Indeed, we detected no new brain infarction since blood flow was always guaranteed.

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