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Chapter-11 Flow Diversion: New Paradigm for Cerebral Aneurysms

BOOK TITLE: Neurovascular Surgical Techniques

Author
1. Jabbour Pascal M
2. Dumont Aaron S
3. Gonzalez L Fernando
4. Rosenwasser Robert H
5. Tjomakaris Stavropoula I
ISBN
9789350900888
DOI
10.5005/jp/books/11824_11
Edition
1/e
Publishing Year
2013
Pages
8
Author Affiliations
1. Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
2. Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
3. Thomas Jefferson University, 909 Walnut Street, Philadelphia, Pennsylvania, USA
4. Thomas Jefferson University Hospital, 901 Walnut Street, Philadelphia, Pennsylvania, USA
5. Thomas Jefferson University Hospital, 901 Walnut Street, Philadelphia, Pennsylvania, USA
Chapter keywords
Cerebral aneurysms, craniotomy, clipping, flow diversion, endoluminal therapy, coil embolization, thrombosis, clot formation

Abstract

The cerebral aneurysms was treated by two therapeutic interventions i.e. craniotomy and clipping. The goal of all aneurysm treatments is to eliminate the aneurysm from the circulation and to prevent the risk of rupturing which occurs in 1%/year. The concept of flow diversion represents a new way to treat aneurysms without having to deploy devices within the aneurysm itself, this is known as endoluminal therapy here the artery is reconstructed by eliminating the aneurysm. With a surgical clip the aneurysm is eliminated immediately from the circulation; with coil embolization the volume of the aneurysm is replaced by about 30% with platinum coils the rest is left for thrombosis and clot formation within the interstices among the coils. Reconstruction starts immediately after the device is placed and takes weeks to months to complete obliteration of it. This technology offers promising results although the timing and the occlusion rate seems unpredictable and is associated with a significant higher incidence of complications.

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