Cerebral Artery Fenestration and Endovascular Treatment
Summary
Cerebral artery fenestration is a congenital vascular variant in which a single arterial trunk divides into two parallel channels that subsequently rejoin. Although often asymptomatic, fenestrations can alter local haemodynamics, predispose to thrombus formation or aneurysm development, and complicate neurovascular interventions. Improved imaging modalities such as three-dimensional rotational angiography, computed tomography angiography and magnetic resonance angiography have increased detection rates in anterior communicating, vertebrobasilar and middle cerebral arterial segments. Computational fluid dynamics studies reveal disturbed shear patterns at fenestration limbs that may foster plaque instability or embolic events. Endovascular treatment has become the preferred approach for fenestration-related aneurysms and dissections, offering coil embolisation, flow-diversion stents and balloon-assisted techniques that respect perforator origins and fenestration morphology. Case series demonstrate high technical success and low complication rates, although precise device selection and microcatheter navigation remain challenging. Multidisciplinary management, combining haemodynamic analysis, advanced imaging and tailored endovascular strategies, holds promise for minimising ischaemic and haemorrhagic risks associated with these vascular variants.
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Cerebral Artery Fenestration and Endovascular Treatment publication trend
The graph below shows the total number of articles in cerebral artery fenestration and endovascular treatment across all publications each year (not limited to Nature Index journals).
Technical terms
Cerebral artery fenestration: A congenital split of an arterial lumen into two parallel channels that reunite distally.
Aneurysm: A focal dilation of an arterial wall prone to rupture or thrombosis.
Endovascular treatment: Minimally invasive, catheter-based techniques for repairing vascular lesions.
Computational fluid dynamics (CFD): A modelling method for analysing blood flow and shear stresses in vascular geometries.
Transcranial Doppler ultrasound: A non-invasive technique to measure cerebral blood flow velocities through the cranial bones.
References
- Imaging and blood flow characteristics of cerebrovascular fenestration malformation and its relationship with the occurrence of ischemic cerebrovascular disease. European Journal of Medical Research (2024).
- Fenestrations of Intracranial Arteries Detected with 3D Rotational Angiography. American Journal of Neuroradiology (2009).
- CTA Evaluation of Basilar Septations: An Entity Better Characterized as Aberrant Basilar Fenestrations. American Journal of Neuroradiology (2021).
- Fenestrations of Intracranial Arteries. American Journal of Neuroradiology (2015).
- Hemodynamic Differences Between Basilar Artery Fenestration and Normal Vertebrobasilar Artery: A Pilot Study. Frontiers in Neurology (2022).
- Endovascular treatment of an aneurysm associated with fenestration of the supraclinoid internal carotid artery: Case report and review of the literature. Frontiers in Neurology (2022).
- Multiple Ruptured Aneurysms Over Basilar Artery Fenestration: Endovascular Management. Cureus (2022).
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