{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T01:28:43Z","timestamp":1781227723864,"version":"3.54.1"},"reference-count":16,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>We present five patients with remodeling of the adult circle of Willis in response to flow diverter stents (FDSs) at the anterior communicating artery (AComA) and the posterior communicating artery (PComA). The observed changes provide a paradigm of how flow change can institute anatomic changes in the adult circle of Willis vasculature.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Case Description: <\/jats:title>\n<jats:p>In the first two cases, after placement of the FDS covering the AComA, there was an increase in size and flow of the contralateral A1-anterior cerebral artery which had previously been hypoplastic. In one of the cases, this led to the filling of the aneurysm and required placement of coils within the lesion which was curative. In case three, the FDS effect led to asymptomatic occlusion of the PComA and associated aneurysm without change of the ipsilateral P1-segement of posterior-cerebral-artery (P1-PCA) caliber. In the fourth case, the FDS covering an aneurysm with a fetal PCA arising from its neck resulted in significant reduction of the aneurysm size, persistent flow and caliber of the fetal PCA, and the hypoplastic ipsilateral P1-PCA. Finally, in the fifth case, after FDS occlusion of the PComA and aneurysm there was increasement in diameter of the ipsilateral P1-PCA that was previously hypoplastic.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>The use of FDS can affect vessels covered by the device and other arteries of the circle of Willis adjacent to the FDS. The phenomena illustrated in the hypoplastic branches appear to be a compensatory response to the hemodynamic changes induced by the divertor and to the altered flow in the circle of Willis.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_1139_2022","type":"journal-article","created":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T06:12:04Z","timestamp":1676009524000},"page":"49","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Plasticity of the adult circle of Willis in response to flow diversion stents"],"prefix":"10.25259","volume":"14","author":[{"given":"Rafael Trindade","family":"Tatit","sequence":"first","affiliation":[{"name":"Department of Medicine, Faculdade Israelita de Ci\u00eancias da Sa\u00fade Albert Einstein, S\u00e3o Paulo, Brazil,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher S.","family":"Ogilvy","sequence":"additional","affiliation":[{"name":"Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max S.","family":"Shutran","sequence":"additional","affiliation":[{"name":"Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabih G.","family":"Tawk","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida, United States,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas A.","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Department of Interventional Neuroradiology, Hospital Benefic\u00eancia Portuguesa de S\u00e3o Paulo, S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Eduardo","family":"Baccin","sequence":"additional","affiliation":[{"name":"Department of Interventional Neuroradiology, Hospital Benefic\u00eancia Portuguesa de S\u00e3o Paulo, S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2023,2,10]]},"reference":[{"key":"10.25259\/SNI_1139_2022\/ref-1","doi-asserted-by":"crossref","first-page":"537","DOI":"10.3174\/ajnr.A4139","article-title":"Patency of the anterior choroidal artery after flow-diversion treatment of internal carotid artery aneurysms","volume":"36","author":"Brinjikji","year":"2015","journal-title":"Am J Neuroradiol"},{"key":"10.25259\/SNI_1139_2022\/ref-2","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.clineuro.2014.02.018","article-title":"Patency of the posterior communicating artery after flow diversion treatment of internal carotid artery aneurysms","volume":"120","author":"Brinjikji","year":"2014","journal-title":"Clin Neurol 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