Journal of Cerebrovascular and Endovascular Neurosurgery

Korean Society of Cerebravascular Surgeons (대한뇌혈관외과학회)
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Circulation remodeling after flow diversion of an anterior communicating artery aneurysm: A case report

  • James Withers (University of New England College of Osteopathic Medicine) ;
  • Robert W. Regenhardt (Department of Neurology, Massachusetts General Hospital, Harvard Medical School) ;
  • Adam A. Dmytriw (Department of Neurology, Massachusetts General Hospital, Harvard Medical School) ;
  • Justin E. Vranic (Department of Radiology, Massachusetts General Hospital, Harvard Medical School) ;
  • Rudolph Marciano (Northern Light Neurosurgery and Spine) ;
  • James D. Rabinov (Department of Neurology, Massachusetts General Hospital, Harvard Medical School)
  • Received : 2022.07.21
  • Accepted : 2022.10.12
  • Published : 2023.09.30
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Abstract

Anterior communicating artery aneurysms are the most common intracranial aneurysm and have a high risk of rupture which can lead to morbidity and mortality. Traditionally, intracranial aneurysms were treated by clipping with neurosurgical access. However, certain patients may prefer less invasive approaches or not represent open surgical candidates. Flow diverters, including flow-redirection endoluminal devices (FRED), are new-generation stents that are placed endovascularly by transfemoral or transradial access. Recent studies have demonstrated that FRED is both safe and effective, with complete occlusion of aneurysms in over 90% of patients. This case highlights an interesting phenomenon of post-flow diversion circulatory remodeling, where flow diverter treatment can alter the circle of Willis anatomy and physiology.

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References

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