Editorial

Twenty years ago, the groundbreaking concept of utilizing flow-diversion to treat intracranial aneurysms emerged. Initially limited to adressing large and proximal lesions, this innovative approach has traversed a remarkable path, and some physicians now report its efficacy in managing complex distal and bifurcation aneurysms.

Over these transformative two decades, flow diverter stents have undergone significant enhancements. Numerous technical improvements have facilitated easier deployment, improved wall apposition, and reduced thrombogenicity.

Enter the latest generation of flow-diverter stents, exemplified by the Pipeline™ Vantage stent. Dr. Hal Rice reflects on the strides made by various Pipeline™ generations and emphasizes the paramount importance of ongoing evaluation in this dynamic and ever-evolving technological landscape.

The Inspire-A registry stands as a distinctive, prospective, and adjudicated comprehensive dataset sponsored by Medtronic. It brings very valuable data on clinical and imaging outcomes in real life settings. As novel devices enter the scene, they pose new challenges. Prof. Jens Fiehler stresses the critical need for standardized evaluations of flow-diverter stent outcomes to ensure robust clinical assessments and comparisons.

Although dual antiplatelet therapy post-stent implantation is the standard of care, unfortunately, there are no guidelines dictating its usage. Dr. Jildaz Caroff delves into an extensive dataset with over 700 patients from the INSPIRE-A registry to explore the impact of antiplatelet therapy duration on clinical outcomes.

While the efficacy of flow-diversion has firmly established its place in the therapeutic arsenal of neurointerventionists, the future appears even more promising. Prof. Vitor Mendes Pereira shares his visionary perspective, discussing new imaging tools advancing our comprehension of flow-diverter treatment and articulating expectations for the forthcoming generations of stents.

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