Controversy surrounding flow diverters in the sylvian artery - Ep.4/4

Flow diverter in the treatment of MCA aneurysms:

After the balloon assisted coiling, Pr. Chapot demonstrated that we must

deflate the balloon to choose the branch in which we should place the Stent.

The branch where there is more movement of coils is the branch where we

should place the Stent and not the easier branch. And he finished the

treatment by placing an Lvis EVO Stent through the Scepter balloon,

emphasizing the quality of these Stents in being able to be repositioned.

Further reading:

1) Piano, M. et al. Flow diverter devices in the treatment of complex middle cerebral artery

aneurysms when surgical and endovascular treatments are challenging. J. Stroke Cerebrovasc.

Dis. 31, 106760 (2022)

2) BhogalP,AlMatterM,Ba ̈znerH,etal.Flowdiversionforthetreat- ment of MCA bifurcation

aneurysms: a single centre experience. Front Neurol 2017;8:20 CrossRef Medline

3) BhogalP,MartinezR,GansladtO,etal.Managementofunruptured saccular aneurysms of the M1

segment with flow diversion: a single centre experience. Clin Neuroradiol 2016 Dec 11. [Epub

ahead of print] CrossRef Medline

4) Briganti F, Napoli M, Leone G, et al. Treatment of intracranial an- eurysms by flow diverter

devices: long-term results from a single center. Eur J Radiol 2014;83:1683–90 CrossRef Medline

5) Caroff J, Neki H, Mihalea C, et al. Flow-diverter stents for the treat- ment of saccular middle

cerebral artery bifurcation aneurysms. AJNR Am J Neuroradiol 2016;37:279 – 84 CrossRef

Medline

6) IosifC,MounayerC,YavuzK,etal.Middlecerebralarterybifurca- tion aneurysms treated by

extrasaccular flow diverters: midterm angiographic evolution and clinical outcome. AJNR Am J

Neurora- diol 2017;38:310 –16 CrossRef Medline

7) F. Cagnazzo, D. Mantilla, P.-H. Lefevre, C. Dargazanli, G. Gascou and V. Costalat American

Journal of Neuroradiology December 2017, 38 (12) 2289-2294

8) Diestro JDB, Adeeb N, Dibas M, et al. Flow Diversion for Middle Cerebral Artery Aneurysms: An

International Cohort Study. Neurosurgery. 2021;89(6):1112-1121