Rescue technique for proximal flow diverter foreshortening leading to dislodgement into aneurysm - 29/10/25

Doi : 10.1016/j.neurad.2025.101389

Yong Zhang ^a,^b,^{^{1
Yong Zhang and Xiguang Fu contributed equally to this work.}}, Xiguang Fu ^a,^b,^{^{1
Yong Zhang and Xiguang Fu contributed equally to this work.}}, Haoyu Zhu ^c,^⁎ , Chuhan Jiang ^a,^b,^⁎
^a Department of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
^b Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
^c Department of Neurosurgery, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, China

^⁎Corresponding authors.

Abstract

Flow diverters (FDs) are an established treatment method for dissecting aneurysms.^{1Liu J.M., Zhou Y., Li Y., Li T., Leng B., Zhang P., e al. Parent artery reconstruction for large or giant cerebral aneurysms using the tubridge flow diverter: a multicenter, randomized, controlled clinical trial (PARAT) AJNR Am J Neuroradiol 2018 ; 39 (5) : 807-816 [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 2Griessenauer C.J., Ogilvy C.S., Adeeb N., Dmytriw A.A., Foreman P.M., Shallwani H., e al. Pipeline embolization of posterior circulation aneurysms: a multicenter study of 131 aneurysms J Neurosurg 2019 ; 130 (3) : 923-935

Cliccare qui per andare alla sezione Riferimenti, 3Becske T., Potts M.B., Shapiro M., Kallmes D.F., Brinjikji W., Saatci I., e al. Pipeline for uncoilable or failed aneurysms: 3-year follow-up results J Neurosurg 2017 ; 127 (1) : 81-88 [cross-ref]

Cliccare qui per andare alla sezione Riferimenti} However, device shortening post-deployment and subsequent migration into the aneurysm may pose significant risks.^{4Gawlitza M., Soize S., Manceau P.F., Pierot L. Delayed intra-aneurysmal migration of a flow diverter construct after treatment of a giant aneurysm of the cavernous internal carotid artery J Neuroradiol 2020 ; 47 (3) : 233-236 [cross-ref]

Cliccare qui per andare alla sezione Riferimenti}^,^{5Tsai Y.H., Wong H.F., Hsu S.W. Endovascular management of spontaneous delayed migration of the flow-diverter stent J Neuroradiol 2020 ; 47 (1) : 38-45 [cross-ref]

Cliccare qui per andare alla sezione Riferimenti} In this technical video (Video 1), we present a case of Pipeline Flex Shield deployment for a dissecting aneurysm in the M1 segment of the left middle cerebral artery, where proximal segment shortening with subsequent device migration into the aneurysm sac was observed during the 9-month follow-up evaluation. In this procedure, we successfully advanced a microwire-guided microcatheter through the proximal portion of the compromised stent. Utilizing an exchange technique, the original delivery catheter was replaced to facilitate deployment of a Lattice flow diverter. Final angiography confirmed adequate overlap between the two stents with re-established luminal patency in the parent artery. n analogous clinical scenarios, telescoping stent deployment within the shortened endoprosthesis may constitute a viable salvage strategy.

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Keywords : Dissecting aneurysm, Complication, Flow diverter, Angiography

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Vol 52 - N° 6

Articolo 101389- novembre 2025 Ritorno al numero

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Rescue technique for proximal flow diverter foreshortening leading to dislodgement into aneurysm - 29/10/25

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