Recurrent reversible in-stent-stenosis after flow diverter treatment

Abstract

Flow diverter stents (FDS) are well established in the treatment of intracranial aneurysms which are difcult to treat with conventional endovascular techniques. However, they carry a relatively high risk of specifc complications compared to conventional stents. A minor but frequent fnding is the occurrence of reversible in-stent-stenosis (ISS) that tend to resolve spontaneously over time. Here, we report the case of a patient in their 30s who was treated with FDS for bilateral paraophthalmic internal carotid artery (ICA) aneurysms. ISS were found at the respective early follow-up examinations on both sides and had resolved at the 1-year follow-up examinations. Surprisingly ISS reoccurred at both sides in later follow-up examinations and again resolved spontaneously. The recurrence of ISS after resolution is a fnding that has not been described previously. Its incidence and further development should be investigated systematically. This might contribute to our understanding of the mechanisms underlying the efect of FDS.