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Flow Diverter Surgery for Aneurysm

Why is Aneurysm?

An aneurysm is a lump in vein vessel as a result of weakness in the blood vessel walls. Aneurysms can develop in any blood vessel in the body, but the most common is the abdominal aorta (the artery that transports blood away from the heart to the rest of the body) and the brain. Most brain aneurysms only cause noticeable symptoms if it ruptures. The risk of the occurrence of an aneurysm may also be dependent on the condition of the patient, i.e. if the patient has a family history of aneurysm or if the patient is influenced by some other external factors like smoking, high blood pressure and high cholesterol. The major symptoms for Aneurysm include:

• A sudden agonising headache, often described as thunderclap or sudden hit on the road.
• Stiff Neck
• Vomiting and sickness
• Headache while looking towards light.

What is Flow Diverter?

Flow Diverter is an endovascular technique in which the surgeons instead of placing the device in the aneurysm sac place it in the parent blood vessel to divert blood flow away from the aneurysm itself. The risk of rupturing the aneurysm during surgery is greatly reduced by not placing a device inside the aneurysm. The flow diverting device, also known as Pipeline Embolization Device, is employed along the neck of the aneurysm in the parent blood vessel where the aneurysm is situated.

Usually brain aneurysm does not show any symptoms and pass undetected. Flow diverters are known to allow endoluminal reconstruction rather than endovascular filling. When it is used for fusiform aneurysms these processes allow reconstruction of a smooth endothelial covered channel along with their parent artery. Hence these features are thought to allow for durable reduction in rupture rates.

Various coiling techniques, including balloon-assisted coiling and stent-assisted coiling, are aimed towards the aneurysm sac, Flow Diverters represent a paradigm shift with the occlusion being carried out in the parent artery itself. Structurally, the flow diverting stents are made up of nitinol or Cobalt-Chrome alloy wires and are often woven together with a set of radiopaque wires in flexible bullion. Flow diverter embolization can also be combined with Coil embolization, which can further increase the number of options available to the patients as well as the doctors.

Flow Diverter Procedure:

In Flow Diversion, a miniaturized scale catheter is guided past the aneurysm without really having to enter the aneurysm. At that point, the flow diverting device, called Pipeline Embolization Gadget, is used along the neck of the aneurysm in the parent vein where the aneurysm is located. Hypothetically, as opposed to filling within the aneurysm sac like in ordinary cases, flow diverters take into consideration rebuilding in the vein. Flow diverters initiate changes in the interface of the aneurysm sac like adjustments in the flow of the blood to actuate aneurysm thrombosis. After the stream preoccupation gadget is sent, thrombosis inside the aneurysm sac pursues. The excess of the scar tissue will consequently cover the stent and will thus reestablish the parent conduit wiping out the aneurysm/parent vessel interface. The irritation of the aneurysm may now and again be joined by transitory swelling in the encompassing mind tissue. Flow diverters exploit thrombosis, blood stream, re-development of the cells within the dividers of the veins, mending and irritation to accomplish reclamation and the devastation of the aneurysm. As opposed to that of the loop embolization strategy, stream redirection procedures accomplish impediment in the aneurysm after some time.

Surviving Brain Aneurysm through Flow Diverter Surgery India

Jena Williams, Australia

"Suffering from any kind of brain problem is the worst ailment one can have. Mostly, the brain issues require surgery and have heavy risks involved which causes complications in the treatment process. Thus, when I was diagnosed with one, the only option in front of me was to undergo a surgical treatment. I was scared to even ask the doctor about my survival probability but my surgeon explained me everything about the option of the flow diversion insertion with so much patience that I was feeling relived after the very first meeting. He really gave me the confidence that it can be cured and that my survival rates can increase and they did."

Advantages of Flow Diverter:

Flow Diversion is the latest endovascular technique and has many advantages over the conventional methods; some of the advantages are listed below:

• Flow diverters take advantage of hemodynamic, thrombosis, inflammation, healing, and endothelial regrowth to achieve endoluminal reconstruction and aneurysm obliteration.
• Allows reconstruction of smooth endothelial channel in continuation with the parent artery.
• Flow diverters are mainly functional in the areas where coiling method is difficult to pursue, as the coils have a propensity of filling the parent artery.
• Flow diverters have been developed to treat intracranial aneurysms.
• Flow Diversion also provides higher rate of obstruction in comparison to that of coil embolization, with no additional morbidity and similar results to coiling.
• Flow diversion procedure can also be used for the treatment of unruptured brain aneurysm.

Risks Associated with Flow Diverters:

• The procedure also increases the risk of blood clotting which in turn can close off the affected artery and can interrupt the flow of Oxygen and blood to the Brain.
• Flow diverters increase the risk of strong not only because of blood clotting but also due to the plaque formation.
• The patients are placed on dual anti-platelet therapy for an extended period of time, to reduce the likelihood of complications of peri-procedural and post-procedural blood vessel obstruction.