Endovascular techniques for achievement of better flow diverter wall apposition

Interv Neuroradiol. 2019 Jun;25(3):344-347. doi: 10.1177/1591019918815294. Epub 2018 Nov 28.

Abstract

Flow diverter malapposition has been described as a technical complication during endovascular procedures and can be associated with, potentially delayed, life-threatening aneurysm rupture or ischemic events. We performed a retrospective review of our flow diverter database to identify all patients in whom device malapposition was detected on follow-up angiogram immediately after device deployment. Feasibility and technical success of different endovascular approaches aiming to correct the inadequate vessel wall apposition were evaluated. Successful endovascular techniques for manipulation of the flow diverter included use of wires, catheters and additional flow diverter/stent devices. In our practice, we found six successful endovascular techniques for device manipulation, which allowed us to safely achieve good flow diverter wall apposition.

Keywords: Wall apposition; aneurysm; balloon angioplasty; flow diverter; malapposition; stent.

MeSH terms

  • Aged
  • Angioplasty, Balloon / methods
  • Brain Ischemia / surgery
  • Catheters
  • Databases, Factual
  • Endovascular Procedures / instrumentation
  • Endovascular Procedures / methods*
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / surgery*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Spiral Cone-Beam Computed Tomography
  • Stents
  • Treatment Outcome
  • Vascular Grafting / instrumentation
  • Vascular Grafting / methods*