Blood Flow Diversion as a Primary Treatment Method for Ruptured Brain Aneurysms-Concerns, Controversy, and Future Directions.
Neurocrit Care
; 26(3): 465-473, 2017 Jun.
Article
em En
| MEDLINE
| ID: mdl-27844465
ABSTRACT
Flow diversion is a novel treatment for brain aneurysms that works by redirecting blood flow away from the aneurysm. Immediately after placement of the stent, blood flow stagnates within the aneurysm dome and it undergoes thrombosis. Over time, a new endothelium develops across the neck, thereby reconstructing the parent vessel and curing the aneurysm. The use of this treatment method for ruptured aneurysms has two specific concerns 1) risk of hemorrhage from the aneurysm after treatment because of potential delayed aneurysm occlusion; and 2) hemorrhagic complications from antiplatelet use, which is required to prevent thromboembolic complications from the device. In this review, we explore these two concerns based on the emerging published literature. Optimal peri-procedural management of these issues in the neurocritical care setting is vital to improving outcomes. We also identify ongoing clinical trials of flow diversion for the treatment of ruptured aneurysms. Flow diversion is an alternative to clipping or coiling for many ruptured aneurysms and may be potentially more efficacious in certain aneurysm subtypes.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Tromboembolia
/
Stents
/
Aneurisma Intracraniano
/
Circulação Cerebrovascular
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Aneurisma Roto
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Procedimentos Neurocirúrgicos
/
Procedimentos Endovasculares
Limite:
Humans
Idioma:
En
Revista:
Neurocrit Care
Assunto da revista:
NEUROLOGIA
/
TERAPIA INTENSIVA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Estados Unidos