AUTHOR=Xie Dajiang , Yang Heng , Zhao Li , Ye Xin , Yang Shuxu , Gao Chao , Tian Yanlong , Ni Wei , Gu Yuxiang 

TITLE=Tubridge flow diverter for the treatment of small and medium aneurysms

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1054631

DOI=10.3389/fneur.2023.1054631

ISSN=1664-2295

ABSTRACT=Background: Tubridge flow diverter is a widely used device aimed at reconstructing parent artery and occluding complex aneurysm in China. The experience of Tubridge in treating small and medium aneurysms is still limited. In this study, we aimed to evaluate the safety and efficacy of Tubridge flow diverter for the treatment of the two types of aneurysms.
Methods: We reviewed the clinical records of aneurysms treated with a Tubridge flow diverter between 2018 and 2021 in a national cerebrovascular disease center. Cases were divided into small and medium aneurysms according to aneurysm size. Therapeutic process, occlusion rate and clinical outcome were compared.
Results: Fifty-seven patients and seventy-seven aneurysms were identified. The patients were divided into two groups: small aneurysms (39 patients, 54 aneurysms), and medium aneurysms (18 patients, 23 aneurysms). There were 19 patients with tandem aneurysms (totally 39 aneurysms) in the two groups, among which 15 patients (30 aneurysms) in small aneurysm group and 4 patients (9 aneurysms) in medium aneurysm group. The results show that the mean maximal diameter /neck in the small aneurysms and medium aneurysms were 3.68/3.25 mm and 7.61/6.24 mm, respectively. Fifty-seven Tubridge flow diverters were successfully implanted without unfold failure, and there were 6 patients with new mild cerebral infarction in the small aneurysm group. The complete occlusion rate on the last angiographic follow-up was achieved in 88.46% of the small aneurysms group, 81.82% of the medium aneurysms group. The complete occlusion rate of patients with tandem aneurysms on the last angiographic follow-up was 86.67% (13/15) of the small aneurysms group, 50% (2/4) of the medium aneurysm group. Intracranial hemorrhage was nonencountered in the two groups.
Conclusions: Our preliminary experience suggests that the Tubridge flow diverter might be a safe and effective treatment for small and medium aneurysms along the internal carotid artery. Long stents may increase the risk of cerebral infarction. Adequate evidence is required to clarify the definite indications and complications in a multicenter randomized controlled trial with a long-term follow-up.