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Non-ischemic cerebral enhancing (NICE) lesions after flow diversion for intracranial aneurysms: a multicenter study
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  • Published on: 11 January 2024
    Comprehensive Analysis of Non-ischemic Cerebral Enhancing (NICE) Lesions Following Flow Diversion for Intracranial Aneurysms: Implications and Research Imperatives
    • Poorya Kheyrandish, MD Student Research Committee, Shiraz University of Medical Science, Shiraz, Iran

    Dear Editor,

    I am writing to express my appreciation for the recent publication of the multicenter study entitled "Non-ischemic cerebral enhancing (NICE) lesions after flow diversion for intracranial aneurysms: a multicenter study." The investigation sheds light on a relatively underexplored aspect of neuroendovascular procedures and provides valuable insights into the incidence, clinical presentation, and potential device-related factors associated with NICE lesions.

    The study, conducted across eight centers, presents a meticulous analysis of 15 patients with NICE lesions following flow diversion. Notably, the reported incidence of 1% raises concerns given its contrast with rates observed in previous studies on various neuroendovascular procedures. This finding underscores the need for a closer examination of the potential risks and implications of flow diversion in the context of NICE lesions.

    One of the notable contributions of this study is the identification of a concerning accumulation of NICE lesion cases associated with specific product lines—Pipeline devices and Derivo devices. While the study rules out the device material itself as the exclusive culprit, the hypotheses put forth regarding mechanical properties, vendor-specific catheters, and the call for further bench testing and transparent disclosure of technical details add depth to the discussion. This nuanced exploration of potential contributing factors sets the stage for more...

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    Conflict of Interest:
    None declared.