Over the last 2 decades, the field of transcriptomics has emerged as a major subdiscipline in biology. Transcriptomic techniques have been used by many groups over this time to better understand intracranial aneurysm development, rupture, and treatment. However, only a few studies have applied transcriptomics to understand the mechanisms behind flow diversion (FD) specifically, despite its increasing importance in the neurointerventional armamentarium. FD is an increasingly safe and effective treatment option for intracranial aneurysms. However, the clinical understanding and use of FD has far outpaced the understanding of the underlying mechanisms. To make FD more predictable, clinically efficacious, and safe, it is important to understand the biological mechanisms at play that lead to successful and unsuccessful FD. In this review, the authors focus on the current understanding of FD biology, the recent advances in transcriptomics, and what future studies could be performed to deepen the understanding of FD. They propose the new concept of the FD microenvironment to be studied, which may unlock a deeper biological understanding. This review provides the background for prospective studies into the development of targeted aneurysm therapy, whether by modified devices or by medical adjuncts.

中文翻译：

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颅内动脉瘤的转录组学：血流改道的现状和机会。

在过去的二十年里，转录组学领域已成为生物学的一个主要分支学科。在此期间，许多团体已使用转录组学技术来更好地了解颅内动脉瘤的发展、破裂和治疗。然而，尽管转录组学在神经介入治疗中的重要性日益增加，但只有少数研究应用转录组学来具体了解血流转移 (FD) 背后的机制。FD 是一种日益安全有效的颅内动脉瘤治疗选择。然而，对 FD 的临床理解和使用远远超过了对其潜在机制的理解。为了使 FD 更加可预测、临床有效且安全，了解导致 FD 成功和不成功的生物学机制非常重要。在这篇综述中，作者重点关注了目前对 FD 生物学的理解、转录组学的最新进展，以及未来可以进行哪些研究来加深对 FD 的理解。他们提出了待研究的 FD 微环境的新概念，这可能会解锁更深入的生物学理解。这篇综述为开发靶向动脉瘤治疗（无论是通过改良设备还是通过医疗辅助手段）的前瞻性研究提供了背景。