Flow Diverter Placement is a cutting-edge, minimally invasive endovascular procedure used to treat complex, large, wide-neck, or fusiform brain aneurysms—which are often unsuitable for conventional treatments like coiling or surgical clipping.
Flow diverters are tiny mesh-like stent devices that are placed inside the artery at the site of the aneurysm. They work by redirecting blood flow away from the aneurysm sac, promoting gradual clotting within the aneurysm and allowing the artery to heal over time.
At CARE CHL Hospital, Indore, Dr. Alok K. Udiya, a leading Interventional Neuroradiologist, offers flow diverter therapy using the latest-generation devices such as Pipeline Embolization Devices (PED) and Surpass Evolve. With expertise in advanced neurointervention, he provides this life-saving solution to patients who previously had no safe treatment options.
Key Benefits of the Treatment
Flow diverter stenting offers revolutionary advantages for treating previously untreatable aneurysms:
- Ideal for Wide-Neck or Giant Aneurysms: Especially those located in the internal carotid artery or vertebrobasilar circulation.
- Non-Surgical: Performed via a catheter, eliminating the need for brain surgery.
- No Coils Required: The device itself redirects blood flow, removing the need for packing the aneurysm with coils.
- Permanent Solution: Promotes natural healing and re-endothelialization of the artery wall.
- Reduced Recurrence Rate: Much lower than traditional coiling techniques.
- Short Recovery Time: Patients typically recover faster with minimal hospitalization.
- Prevents Rupture: Especially in large, unruptured aneurysms with high rupture risk.
How This Treatment Works
Flow diverter placement is performed in a neurointervention suite under general anesthesia or conscious sedation, using advanced fluoroscopy (X-ray) guidance.
1. Initial Evaluation and Imaging
Before proceeding, the following assessments are done:
- Digital Subtraction Angiography (DSA) – to map aneurysm shape and vessel anatomy.
- MRI/MRA or CTA – to assess brain parenchyma and rupture risk.
- Blood tests to evaluate platelet count, clotting profile, and renal function.
The aneurysm is classified as:
- Saccular, fusiform, or dissecting
- Wide-neck or narrow-neck
- In a critical vessel (e.g., ICA, MCA, basilar artery)
2. Pre-Procedure Preparation
- Patients are started on dual antiplatelet therapy (aspirin and clopidogrel) 5–7 days before the procedure.
- Fasting is required for 6–8 hours before the procedure.
- Consent and education about recovery and medication compliance are provided.
3. The Procedure
- A catheter is introduced through the femoral or radial artery and navigated to the affected cerebral artery.
- A flow diverter device is deployed across the aneurysm neck.
- This stent-like mesh redirects blood flow, reducing pressure inside the aneurysm.
- Over time, the aneurysm clots and heals as the vessel wall is reconstructed.
The procedure usually takes 1–2 hours.
4. Post-Procedure Care
- Patients are monitored in the ICU for 24–48 hours.
- Imaging is repeated after 3–6 months to confirm aneurysm occlusion.
- Dual antiplatelet therapy is continued for at least 6 months.
- Most patients return to normal activity within 1–2 weeks.
Why Choose Dr. Alok K. Udiya at CARE CHL Hospital?
Flow diverter placement is a specialized neurointerventional technique available only at advanced stroke and neurovascular centers. Dr. Alok K. Udiya offers:
- Extensive experience in complex and wide-neck aneurysm treatment
- Expertise in deploying Pipeline, Surpass, and Silk flow diverters
- Use of biplane DSA suite for accurate device placement
- High success rate with minimal complications
- Personalized decision-making based on aneurysm type, size, and location
- Seamless care coordination with neurologists and neurosurgeons
FAQs – Flow Diverter Placement
Q1. What is a flow diverter?
A flow diverter is a stent-like device made of fine metal mesh. It is placed inside the blood vessel to divert flow away from an aneurysm and allow it to heal naturally.
Q2. When is flow diverter therapy needed?
It is indicated for:
- Large or giant aneurysms
- Wide-neck aneurysms
- Aneurysms that are not suitable for coiling or clipping
- Patients with recurrent aneurysms after prior treatment
Q3. How is it different from coiling?
Coiling involves filling the aneurysm with metal coils. Flow diverters don’t enter the aneurysm sac but rather sit across the neck to redirect blood flow, making them ideal for complex cases.
Q4. Is it safe?
Yes. In skilled hands, the complication rate is low. Risks include:
- Stroke or clot formation
- Stent thrombosis if medication is not followed
- Delayed aneurysm rupture (very rare)
Q5. Will the aneurysm disappear immediately?
No. The aneurysm shrinks gradually over weeks to months as the body heals. Complete occlusion is typically seen in 3–6 months.
Q6. How long do I need to take medication?
You’ll be on dual antiplatelet therapy (DAPT) for 6 months, and possibly aspirin for life, depending on follow-up results.
Q7. How successful is flow diverter therapy?
Studies show 80–95% success in completely healing the aneurysm over time. Recurrence is significantly lower compared to coiling.
Q8. Can I have an MRI after flow diverter placement?
Yes. Most flow diverters are MRI-compatible. Always inform your radiologist about the implanted device.
Q9. Can ruptured aneurysms be treated with flow diverters?
Generally, flow diverters are used for unruptured aneurysms or in select cases of recurrent rupture. Coiling or clipping is preferred in emergencies.
Q10. Is this covered by insurance?
Yes. Many major insurance policies and government health schemes now cover flow diverter placement under neurovascular treatments.