Brina, O.Bouillot, P.Reymond, P.Luthman, A. S.Santarosa, C.Farhat, M.Lovblad, K. O.Machi, P.Delattre, B. M. A.Pereira, V. M.Vargas, M. I.2019-12-292019-12-292019-12-292019-12-0110.3174/ajnr.A6312https://infoscience.epfl.ch/handle/20.500.14299/164232WOS:000502708500026BACKGROUND AND PURPOSE: Flow-diverter stents are widely used for the treatment of wide-neck intracranial aneurysms. Various parameters may influence intracranial aneurysm thrombosis, including the flow reduction induced by flow-diverter stent implantation, which is assumed to play a leading role. However, its actual impact remains unclear due to the lack of detailed intra-aneurysmal flow measurements. This study aimed to clarify this relationship by quantitatively measuring the intra-aneurysmal flow using 4D phase-contrast MR imaging. MATERIALS AND METHODS: We acquired prospective pre- and post-stent implantation 4D phase-contrast MR imaging data of a consecutive series of 23 patients treated with flow-diverter stents. Velocity field data were combined with the intraprocedural 3D angiogram vessel geometries for precise intracranial aneurysm extraction and partial volume correction. Intra-aneurysmal hemodynamic modifications were compared with occlusion outcomes at 6 and 12?months. RESULTS: The averaged velocities at systole were lower after flow-diverter stent implantation for all patients and ranged from 21.7 ? 7.1?cm/s before to 7.2 ? 2.9?cm/s after stent placement. The velocity reduction was more important for the group of patients with aneurysm thrombosis at 6?months (68.8%) and decreased gradually from 66.2% to 55% for 12-month thrombosis and no thrombosis, respectively (P = .08). CONCLUSIONS: We propose an innovative approach to measure intracranial flow changes after flow-diverter stent implantation. We identified a trend between flow reduction and thrombosis outcome that brings a new insight into current understanding of the flow-diversion treatment response.Clinical NeurologyNeuroimagingRadiology, Nuclear Medicine & Medical ImagingNeurosciences & Neurologypipeline embolization deviceblood-flowendovascular treatmentdiversionhemodynamicsdivertorsrupturetext::journal::journal article::research article