ArticleNeuroradiology2013
Endovascular treatment with flow diverters may fail to occlude experimental bifurcation aneurysms.
Article in Neuroradiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Flow diversion: what can clinicians learn from animal models?Neuroradiology · 2017Pooled it
- Surpass flow diverter in the treatment of intracranial aneurysms: a prospective multicenter study.AJNR. American journal of neuroradiology · 2015Trial
- Flow diverter treatment for proximal middle cerebral artery non-saccular aneurysms: multicenter efficacy and safety analysis.Frontiers in neurology · 2025Article
- Effect of the Shelving Technique on the Outcome of Embolization in Intracranial Bifurcation Aneurysms.AJNR. American journal of neuroradiology · 2022Article
- Neck Location on the Outer Convexity is a Predictor of Incomplete Occlusion in Treatment with the Pipeline Embolization Device: Clinical and Angiographic Outcomes.AJNR. American journal of neuroradiology · 2021Article
- Testing Stenting and Flow Diversion Using a Surgical Elastase-Induced Complex Fusiform Aneurysm Model.AJNR. American journal of neuroradiology · 2017Article
- Towards Predicting Patient-Specific Flow-Diverter Treatment Outcomes for Bifurcation Aneurysms: From Implantation Rehearsal to Virtual Angiograms.Annals of biomedical engineering · 2016Article
- Uncertainty and agreement regarding the role of flow diversion in the management of difficult aneurysms.AJNR. American journal of neuroradiology · 2015Article
- Flow diverters for intracranial aneurysms.Stroke research and treatment · 2014Review
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Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAnimal models may explain how stents and flow diverters (FDs) may succeed or fail to treat bifurcation aneurysms.
methodsIn vitro studies were designed to anticipate device deformations in bifurcations. Large, wide-necked bifurcation aneurysms were constructed in 21 animals and treated 4-8 weeks later using stents and FDs in various combinations, forming four main groups: parent artery to right branch flow diversion (RBFD, n = 6), parent artery to left branch flow diversion (LBFD, n = 6), Y flow diversion (YFD, n = 4), and compared with high-porosity Y-stenting (YHPS, n = 4). The results include immediate and follow-up angiography at 3 months, followed by grading of the extent of neointimal coverage of devices at pathology.
resultsIn vitro, all braided devices showed varying porosities according to characteristic zones. FDs can be compacted to decrease porosities, but a limiting factor is the constant presence of a more porous transition zone. In vivo, 3/6 RBFD, 4/6 LBFD, and 2/4 YFD treated aneurysms had decreased in size by 3 months, while those treated with YHPS increased in size (P = 0.15). There was a significant correlation between device porosities and extent of neointimal coverage (r = 0.639, P = 0.002), and between porosities and angiographic evolution (r = -0.655, P = 0.002), but not between neointima formation and angiographic evolution (r = -0.278, P = 0.235). Failures could be explained in all cases by the presence of leaks or holes in the neointima at the level of the transition zones.
conclusionFDs did not successfully treat most bifurcation aneurysms, at least in this animal model.
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