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Flow-diverter stent

Last revised by Arlene Campos on 7 May 2024

Flow-diverter stents are important devices in the management of intracranial aneurysms in both acute and elective settings, especially ones that are large, broad-necked, or fusiform.

Complications

Understanding the complication rates is important in obtaining informed consent from patients. In general, the rate of permanent morbidity is 3.7% and mortality 2.8%, as reported by a meta-analysis 7. Ruptured aneurysms and aneurysms at the posterior circulation are associated with a higher rate of complications 7. Other specific complications include:

  • intra-operative rupture (1.9%) 8

  • delayed aneurysm rupture (1.0%) 8

  • thromboembolic event (4.9%) 8, patients usually need a period of antiplatelet therapy to mitigate the risk

  • side branch occlusions, such as ophthalmic artery and anterior choroidal artery

  • peri-aneurysmal edema, that is extension of the inflammatory process accompanying aneurysm thrombosis causing adjacent cerebral edema

History and etymology

Somewhat surprisingly the word 'stent' is actually an eponym, originally named after Charles Stent (1807-1885), a largely-forgotten British dentist. He invented an improved material for forming dental impressions, and set up a company to manufacture it. During the Great War, J F Esser, a Dutch surgeon used a mold of Stent's Compound as a fixative for skin grafting in injured infantrymen. This innovative use, was rapidly adopted into practice, and stenting as a concept rapidly segued into multiple specialties 6.

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