Intimal hyperplasia detection after aneurysm treatment by flow diversion using magnetic resonance vessel wall imaging

: In-stent caliber reduction due to neo-intimal hyperplasia (NIH) is an underestimated event that may follow flow diverter stent (FDS) implantation. Although mostly asymptomatic, this vascular reaction is a well-known risk factor for delayed ischemic strokes. Here we report on the contribution of magnetic resonance vessel wall imaging (MR-VWI), performed on a 1.5 T scanner, to detect in-stent stenosis and mural inflammation in a 40-year-old woman with cerebral aneurysm previously treated with FDS and presenting with motor disturbances on follow-up. Digital subtraction angiography and cone-beam CT confirmed 1.5 T MRVWI findings, highlighting the potential value of this non-invasive imaging technique in investigating and detecting NIH.