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Bioresorbable flow diverters for the treatment of intracranial aneurysms: review of current literature and future directions
  1. Alexander A Oliver1,2,3,
  2. Kent D Carlson3,
  3. Cem Bilgin2,
  4. Jorge L Arturo Larco4,
  5. Ramanathan Kadirvel2,
  6. Roger J Guillory II5,
  7. Dan Dragomir Daescu1,3,
  8. David F Kallmes1,2
  1. 1Biomedical Engineering and Physiology, Mayo Clinic Graduate School of Biomedical Sciences, Rochester, Minnesota, USA
  2. 2Radiology, Mayo Clinic, Rochester, Minnesota, USA
  3. 3Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
  4. 4Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA
  5. 5Biomedical Engineering, Michigan Technological University, Houghton, Michigan, USA
  1. Correspondence to Mr Alexander A Oliver, Biomedical Engineering and Physiology, Mayo Clinic Graduate School of Biomedical Sciences, Rochester, Minnesota, USA; Oliver.Alexander{at}mayo.edu; aaoliver{at}mtu.edu

Abstract

The use of flow diverters is a rapidly growing endovascular approach for the treatment of intracranial aneurysms. All FDA-approved flow diverters are composed of nitinol or cobalt-chromium, which will remain in the patient for the duration of their life. Bioresorbable flow diverters have been proposed by several independent investigators as the next generation of flow diverting devices. These devices aim to serve their transient function of occluding and healing the aneurysm prior to being safely resorbed by the body, eliminating complications associated with the permanent presence of conventional flow diverters. Theoretical advantages of bioresorbable flow diverters include (1) reduction in device-induced thrombosis; (2) reduction in chronic inflammation and device-induced stenosis; (3) reduction in side branch occlusion; (4) restoration of physiological vasomotor function; (5) reduction in imaging artifacts; and (6) use in pediatric applications. Advances made in the similar bioresorbable coronary stenting field highlight some of these advantages and demonstrate the feasibility and safety of bioresorbable endovascular devices in the clinic. The current work aims to review the progress of bioresorbable flow diverters, identify opportunities for further investigation, and ultimately stimulate the advancement of this technology.

  • Flow Diverter
  • Aneurysm
  • Material
  • Stent

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Footnotes

  • Contributors AAO, RK, RJG, and DFK contributed to the conception of the manuscript, AAO, KDC, CB, JLAL, RJG, and DFK contributed to drafting the manuscript, and DDD and DFK provided manuscript oversight. All authors critically reviewed the manuscript and approved it for submission.

  • Funding This work was funded by National Institutes of Health grant number R01NS076491.

  • Competing interests DFK is a stockholder/shares ownership in Marblehead Medical, Conway Medical, Superior Medical Experts, and Nested Knowledge. He has received research support from MicroVention, Medtronic, Balt, Cerenovus, Monarch Medical, NeuroGami, Endomimetics, and Ancure, but no direct support for the present project. RK has received research support from Medtronic, Cerenovus, Monarch Medical, NeuroGami, Endomimetics, Frontier Bio, Endovascular Engineering, and Ancure, but no direct support for the present project. All other authors declare no conflicts of interest.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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