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Background: The feasibility of transcranial color flow imaging (TC-CFI) for evaluation of in-stent flow after flow diverter stenting has not been clarified. Case: A 59-year-old man was admitted due to headache and was diagnosed as having a dissecting aneurysm of the right vertebral artery (RVA) by magnetic resonance angiography (MRA) and cerebral angiography. Although he was discharged after conservative therapy, he was readmitted due to worsening of his headache 2 months later. Since brain MRA showed enlargement of the dissecting aneurysm, he was treated with flow diverter stenting on day 14 after admission. A 4.5 × 18 mm Pipeline Flex embolization device with Shield technology was placed in the RVA across the dissecting aneurysm. Mild stenosis at the distal part of the Pipeline remained even after percutaneous transluminal angiography. MRA on postoperative day 1 showed decreased signals in the RVA inside the Pipeline. For evaluation of in-stent stenosis, TC-CFI by the foramen magnum approach was performed. The Pipeline was slightly visible on two-dimensional images. TC-CFI at the RVA inside the Pipeline was performed uneventfully and demonstrated normal flow findings, suggesting the absence of in-stent stenosis. Conclusions: TC-CFI can be used to evaluate in-stent flow after flow diverter stenting. [ABSTRACT FROM AUTHOR]

血流导向装置（flow diverter，FD）是近年来产生的血管内治疗颅内复杂动脉瘤的新材料。 FD设计是通过改建血流的方式将动脉瘤排除在循环系统之外从而重建载瘤动脉，因此FD为复杂动 脉瘤的治疗提供了新的思路和手段。临床报道该治疗方式的动脉瘤完全栓塞率可达90%以上。目前 FD应用逐渐广泛，本文从血流动力学角度出发针对FD的血流导向能力，以及颅内动脉瘤经FD治疗后 影响预后的因素进行了总结。 Abstract: Flow diverter (FD) is a kind of new device for endovascular treatment of complex intracranial aneurysms. FD is designed to reconstruct parent artery by removing aneurysms from circulatory system through blood flow remodeling. This concept innovation brings new ideas and methods for treating complex aneurysms. It is reported that the complete occlusion rate of aneurysms using FD could achieve over 90%, so currently the FD application is becoming increasingly wider. This article reviewed that the effect of using FD on hemodynamics in treating intracranial aneurysms, and effect of this treatment approach on outcome of intracranial aneurysms, to provide reference for aneurysms treatment decision-making.