ArticleJournal of clinical medicine2019
Delayed Stroke after Aneurysm Treatment with Flow Diverters in Small Cerebral Vessels: A Potentially Critical Complication Caused by Subacute Vasospasm.
Article in Journal of clinical medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 18 citations in OpenAlex.
- Twelve-Month Outcomes of the J-Tube Flow-Diverting Stent for Unruptured Intracranial Aneurysms: a Prospective Multicenter Study.Clinical neuroradiology · 2026Article
- Subacute Stent Deformities as an Underlying Reason for Vessel Stenosis after Flow Diversion with the p64 Stent: Review and Discussion of Biologic Mechanisms and Consequences.AJNR. American journal of neuroradiology · 2025Article
- An increase in flow-diverter oversizing values as an independent risk factor for developing more severe in-stent stenosis. A retrospective single-center study based on flow diversion of supraclinoid internal carotid artery aneurysms.Frontiers in neurology · 2024Article
- Aren't we missing something? Commentary on "Recurrent reversible in-stent-stenosis after flow diverter treatment" by Garner et al.Neuroradiology · 2023Article
- Distal Flow Diversion with Anti-Thrombotically Coated and Bare Metal Low-Profile Flow Diverters-A Comparison.Journal of clinical medicine · 2023Article
- Flow diverter tail malapposition after implantation in the internal carotid artery for aneurysm treatment: a preliminary study.Frontiers in neurology · 2023Article
- L-Arginine reduces downstream vascular contractility after flow-diverting device deployment: A preliminary study in a rabbit model.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2022Article
- Flow Diversion for Intracranial Aneurysms Beyond the Circle of Willis.Frontiers in neurology · 2021Article
- Endovascular Treatment of Intracranial Aneurysms in Small Peripheral Vessel Segments-Efficacy and Intermediate Follow-Up Results of Flow Diversion With the Silk Vista Baby Low-Profile Flow Diverter.Frontiers in neurology · 2021Article
- The use of single low-profile visualized intraluminal support stent-assisted coiling in the treatment of middle cerebral artery bifurcation unruptured wide-necked aneurysm.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2020Article
- Balloon-assisted coiling of intracranial aneurysms using the Eclipse 2L double lumen balloon.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2020Article
- A Fully Automated Method for Segmenting Arteries and Quantifying Vessel Radii on Magnetic Resonance Angiography Images of Varying Projection Thickness.Frontiers in neuroscience · 2020Article
- Flow diverter treatment for MCA M1 aneurysms: clinical outcomes and predictors of occlusion.Frontiers in neurologyArticle
Corrections and comments
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Authors and funding
14 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Flow diversion (FD) is a novel endovascular technique based on the profound alteration of cerebrovascular hemodynamics, which emerged as a promising minimally invasive therapy for intracranial aneurysms. However, delayed post-procedural stroke remains an unexplained concern. A consistent follow-up-regimen has not yet been defined, but is required urgently to clarify the underlying cause of delayed ischemia. In the last two years, 223 patients were treated with six different FD devices in our center. We identified subacute, FD-induced segmental vasospasm (SV) in 36 patients as a yet unknown, delayed-type reaction potentially compromising brain perfusion to a critical level. Furthermore, 86% of all patients revealed significant SV approximately four weeks after treatment. In addition, 56% had SV with 25% stenosis, and 80% had additional neointimal hyperplasia. Only 13% exhibited SV-related high-grade stenosis. One of those suffered stroke due to prolonged SV, requiring neurocritical care and repeated intra-arterial (i.a.) biochemical angioplasty for seven days to prevent territorial infarction. Five patients suffered newly manifested, transient hemicrania accompanying a compensatorily increased ipsilateral leptomeningeal perfusion. One treated vessel obliterated permanently. Hence, FD-induced SV is a frequent vascular reaction after FD treatment, potentially causing symptomatic ischemia or even stroke, approximately one month post procedure. A specifically early follow-up-strategy must be applied to identify patients at risk for ischemia, requiring intensified monitoring and potentially anti-vasospastic treatment.
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