Flow diverters are used for many purposes:
1. Giant aneurysms
2. Dissecting aneurysms
3. Blister aneuryms
4. Fusiform aneuryms
5. Wide neck aneurysms

While many cases have contrast stasis immediately after flow diverter placement, actual aneurysm 'closure' and arterial wall remodeling  and endothelialisation takes place after a variable time-frame.
We came across a case of subarachnoid hemorrhage, wherein DSA showed a irregular mild fusiform dilatation of the supraclinoid ICA with multiple blister like outpouchings.

Single PED Flex was placed, with no immediate change in appearance.
Patient developed vasospasm features, and was taken up for intra-arterial spasmolysis, during which the DSA showed smoothing of the arterial contour and non-visualisation of the blisters.

It can be said with guarantee that endothelialisation has not taken place, and the smoothening is due to the flow diversion effect. Probably the vasospasm also has added to the appearance.

DIAGNOSTIC DSA





FLOW DIVERTER



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