Flow Diversion with Stents for Brain Aneurysms

Brain aneurysm treatments have improved significantly over the past few decades. In the past, doctors performed an intensive open surgery on all patients needing brain aneurysm treatment. Today, many brain aneurysms are treated with less invasive approaches, including flow diverters, stents and other endovascular procedures.

What is flow diversion for brain aneurysms?

Flow diversion is a technique in which your surgeon uses a catheter to place a stent (a soft, flexible mesh tube) into the blood vessel where an aneurysm has formed.

This process immediately diverts the flow of blood away from the aneurysm itself. Rerouting the blood flow takes pressure off the aneurysm so it’s less likely to rupture. In time, new cells grow on the stent, sealing the aneurysm and healing the vessel.

If the stent covers the opening of a branch leading off the vessel, normal flow of blood prevents cells growing on that portion of the stent and blocking the branch, so there is not a risk of the stent cutting off the blood supply to other areas of the brain.

How is flow diversion performed?

Flow diversion is a minimally invasive procedure that does not involve a craniotomy.

While you are under anesthesia, your surgeon inserts a small tube in your leg and carefully guides a narrow, flexible catheter through the blood vessels of your body.

The catheter system is like a telescope and gets narrower the further it goes. The stent, which comes in a range of sizes, is loaded into the very end of the catheter.

When the catheter reaches the brain, the surgeon positions it inside the blood vessel where the aneurysm is present without entering the fragile aneurysm sac.

The stent is put in place and blood flow is immediately rerouted. The surgeon withdraws the catheter and monitors your blood flow to ensure the stent is in proper position. You are awakened and moved into recovery.

Your surgical team monitors you carefully over the next 12 – 24 months as new cells rebuild the blood vessel where your aneurysm occurred.

Ruptured Brain Aneurysm | Dr. Olachi Mezu's Story

As a physician herself, Dr. Olachi Mezu recognized that she was experiencing symptoms of an aneurysm. She sought care at Hopkins with Dr. Judy Huang to repair the aneurysm.

Reasons for Having a Flow Diversion Procedure

A flow diversion procedure may be performed to treat a variety of unruptured brain aneurysms.

To date, surgeons have had excellent results using this minimally invasive technique, and aneurysms have not recurred in vessels treated with this procedure.

The benefits of the flow diversion method include:

Increased safety: This treatment method eliminates the need for doctors to enter the aneurysm itself — which is often the riskiest part of an endovascular approach.

Shorter recovery: Many patients who once needed extensive surgery can now undergo this procedure and go home the next day. Some patients return to work within a week.

Less recurrence: This technique appears to reduce the recurrence rate (the chance a patient will develop another aneurysm).

Less radiation exposure: In this procedure, patients receive a much lower radiation dose than with other endovascular techniques.

Lower costs: This surgery costs less than other endovascular treatment approaches.

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