Mechanism of Action and Biology of Flow Diverters in the Treatment of Intracranial Aneurysms

Krishnan Ravindran, Amanda M. Casabella, Juan Cebral, Waleed Brinjikji, David F. Kallmes, Ram Kadirvel

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Flow diverters have drastically changed the landscape of intracranial aneurysm treatment and are now considered first-line therapy for select lesions. Their mechanism of action relies on intrinsic alteration in hemodynamic parameters, both at the parent artery and within the aneurysm sac. Moreover, the device struts act as a nidus for endothelial cell growth across the aneurysm neck ultimately leading to aneurysm exclusion from the circulation. In silico computational analyses and investigations in preclinical animal models have provided valuable insights into the underlying biological basis for flow diverter therapy. Here, we review the present understanding pertaining to flow diverter biology and mechanisms of action, focusing on stent design, induction of intra-aneurysmal thrombosis, endothelialization, and alterations in hemodynamics.

Original languageEnglish (US)
Pages (from-to)S13-S19
JournalNeurosurgery
Volume86
DOIs
StatePublished - Jan 1 2020

Keywords

  • Endothelialization
  • Endovascular
  • Healing
  • Pipeline embolization device
  • Thrombosis

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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