Due to our wonderful investigative reporters at Frontal we have a small PR catastrophe here. Lamentably a patient died after a flow diverter was used to treat a giant aneurysm of the distal ICA. Now the TV show couldn’t possibly get the details right, but we covered the topic of flow diverters nevertheless, since they are often the only option to treat inoperable and potentially lethal aneurysms (which are rare). In fact, they might become a tool to treat aneurysms more effectively endovascularly since they could break through the pathophysiological cycle that leads to regrowth of the aneurysm – but this is still controversial.
As for references
- here is the latest series on FDs
- here is a recent collection of complications in a postmarket study
- here is a review article in Stroke from 2011
- and here a review article in J Clin Sci of 2011
When evaluating papers about these technical gadgets, consider
- how many acutely bleeding patients were treated (this is problematic since the theory implies that the aneurysm is only slowly shrinking after FD deployment)?
- how many potentially operable aneurysms were treated (there is an ethic controversy)?
- the usual EBM facts (length and completeness of follow-up).