Huang Mengshi, Feng Xin, Wen Zhuohua, Huang Chi, Huang Jiwan, Xu Anqi, Tong Xin, Ma Gengwu, Lin Jiancheng, Shi Hongyu, Hu Yuqi, Yuan Hao, Ge Runze, Li Can, Jia Zhikun, Yi Ruizhe, Jin Yuheng, Liang Shuyin, Li Xifeng, Wang Xuetao, Liu Aihua, Duan Chuanzhi, Zhang Xin
Neurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
Neurointervention Center, Beijing Neurosurgical Institute, Beijing, China.
Neurosurg Rev. 2025 Feb 14;48(1):237. doi: 10.1007/s10143-025-03347-x.
To compare the impact of two flow diverter devices (Pipeline Embolization Device [PED] and Tubridge Embolization Device [TED]) on branch vessels patency in intracranial aneurysm treatment, with specific focus on branch vessel outcomes and clinical safety. A retrospective analysis of 320 patients with 430 aneurysms and 602 covered branches treated with PED or TED was conducted. Statistical analyses included descriptive statistics and group comparisons. Potential predictors of aneurysm and branch occlusion were identified through univariate analysis followed by multivariate logistic regression. Propensity score matching was adjusted for baseline discrepancies, and the comparative analysis examined stent efficacy on branch vessels patency and clinical outcomes. Stenosis or occlusion rates were 6.1% for the ophthalmic artery (OA), 31.6% for the posterior communicating artery (PComA), 0.9% for the anterior choroidal artery (AChA), 40.5% for the anterior cerebral artery (ACA), and 0% for the middle cerebral (MCA), lenticulostriate (LSA), posterior inferior cerebellar (PICA), and anterior inferior cerebellar arteries (AICA). Before propensity score matching, branch vessels patency rates did not significantly differ between the PED and TED groups. After matching, 109 pairs were identified. No significant differences in angiographic outcomes for distal and proximal branch vessels regarding occlusion or stenosis were observed between groups (P values > 0.999 and 0.332, respectively). Branch obliteration was mostly asymptomatic. PED and TED showed comparable safety profiles and branch vessel patency rates. These findings indicate that FD treatment may be clinically safe for selected ICA and VA cases requiring branch vessel coverage.
为比较两种血流导向装置（Pipeline栓塞装置[PED]和Tubridge栓塞装置[TED]）在颅内动脉瘤治疗中对分支血管通畅性的影响，特别关注分支血管结局和临床安全性。对320例患有430个动脉瘤且602个被覆盖分支接受PED或TED治疗的患者进行了回顾性分析。统计分析包括描述性统计和组间比较。通过单因素分析随后进行多因素逻辑回归来确定动脉瘤和分支闭塞的潜在预测因素。采用倾向评分匹配法调整基线差异，比较分析检验支架对分支血管通畅性和临床结局的疗效。眼动脉（OA）的狭窄或闭塞率为6.1%，后交通动脉（PComA）为31.6%，脉络膜前动脉（AChA）为0.9%，大脑前动脉（ACA）为40.5%，大脑中动脉（MCA）、豆纹动脉（LSA）、小脑后下动脉（PICA）和小脑前下动脉（AICA）的狭窄或闭塞率为0%。在倾向评分匹配前，PED组和TED组之间的分支血管通畅率无显著差异。匹配后，确定了109对。两组之间在远端和近端分支血管的造影结局方面，关于闭塞或狭窄均未观察到显著差异（P值分别>0.999和0.332）。分支闭塞大多无症状。PED和TED显示出相当的安全性和分支血管通畅率。这些发现表明，对于需要覆盖分支血管的特定颈内动脉（ICA）和椎动脉（VA）病例，血流导向治疗在临床上可能是安全的。
