Flow diversion changed the treatment of complex intracranial aneurysms by shifting the target from the aneurysm sac to the parent artery. Instead of packing the aneurysm with coils, a densely woven stent-like device is placed across the aneurysm neck to reconstruct the vessel and redirect blood flow along its normal course.
Principle of action
The high metal coverage of a flow diverter reduces inflow into the aneurysm, promoting stasis and progressive thrombosis of the sac over weeks to months. At the same time, the device provides a scaffold along which the vessel wall can heal, endothelializing across the neck and excluding the aneurysm from the circulation.
Device characteristics
- Braid density and pore size determine the degree of flow reduction.
- Radial force and conformability govern wall apposition in curved segments.
- Deliverability through distal, tortuous anatomy is essential for safe placement.
- Surface modifications aim to reduce thrombogenicity and antiplatelet requirements.
Clinical applications and outcomes
Flow diverters are particularly suited to large, wide-necked, fusiform, or blister aneurysms that are difficult to treat with coiling alone. Published series report high rates of complete aneurysm occlusion at follow-up, with occlusion continuing to improve over time. Because occlusion is gradual, the approach is best suited to unruptured aneurysms; ruptured cases require careful individualized judgment.
Peri-procedural management
Dual antiplatelet therapy is central to preventing device thrombosis during endothelialization, and platelet-function considerations guide the regimen. Follow-up imaging documents progressive occlusion and confirms parent-vessel and branch patency.
INVAMED technologies in this space
INVAMED's neurovascular portfolio includes access, navigation, and reconstruction devices; explore the neurovascular interventions category.
Device availability and approved indications vary by country. This content is prepared for healthcare professionals and does not replace clinical judgment or the instructions for use.