• Flow diverter in the treatment of MCA aneurysms:

After the balloon assisted coiling, Pr. Chapot demonstrated that we must deflate the balloon to choose the branch in which we should place the Stent.

The branch where there is more movement of coils is the branch where we should place the Stent and not the easier branch. 

And he finished the treatment by placing an Lvis EVO Stent through the Scepter balloon, emphasizing the quality of these Stents in being able to be repositioned.

• Further reading:

1) Piano, M. et al. Flow diverter devices in the treatment of complex middle cerebral artery aneurysms when surgical and endovascular treatments are challenging. J. Stroke Cerebrovasc. Dis. 31, 106760 (2022)

2) BhogalP,AlMatterM,Ba ̈ znerH,etal.Flowdiversionforthetreat- ment of MCA bifurcation aneurysms: a single centre experience. Front Neurol 2017;8:20 CrossRef Medline

3) BhogalP,MartinezR,GansladtO,etal.Managementofunruptured saccular aneurysms of the M1 segment with flow diversion: a single centre experience. Clin Neuroradiol 2016 Dec 11. [Epub ahead of print] CrossRef Medline

4) Briganti F, Napoli M, Leone G, et al. Treatment of intracranial an- eurysms by flow diverter devices: long-term results from a single center. Eur J Radiol 2014;83:1683–90 CrossRef Medline

5) Caroff J, Neki H, Mihalea C, et al. Flow-diverter stents for the treat- ment of saccular middle cerebral artery bifurcation aneurysms. AJNR Am J Neuroradiol 2016;37:279 – 84 CrossRef Medline

6) IosifC,MounayerC,YavuzK,etal.Middlecerebralarterybifurca- tion aneurysms treated by extrasaccular flow diverters: midterm angiographic evolution and clinical outcome. AJNR Am J Neurora- diol 2017;38:310 –16 CrossRef Medline

7) F. Cagnazzo, D. Mantilla, P.-H. Lefevre, C. Dargazanli, G. Gascou and V. Costalat American Journal of Neuroradiology December 2017, 38 (12) 2289-2294

8) Diestro JDB, Adeeb N, Dibas M, et al. Flow Diversion for Middle Cerebral Artery Aneurysms: An International Cohort Study. Neurosurgery. 2021;89(6):1112-1121