Cerebrovascular Disease
Safety analysis of branch arteries covered by Tubridge flow diverters in treatment of intracra-nial aneurysms
Fang Yibin, Lyu Nan, Zhou Yu, Wu Yi′na, Zhao Rui, Li Qiang, Yang Pengfei, Huang Qinghai, Hong Bo, Xu Yi, Liu Jianmin
Published 2019-10-28
Cite as Chin J Neurosurg, 2019, 35(10): 1017-1021. DOI: 10.3760/cma.j.issn.1001-2346.2019.10.011
Abstract
ObjectiveTo evaluate the safety of branch arteries covered by Tubridge flow diverters (TFDs) in the treatment of intracranial aneurysms.
MethodsThe clinical and angiographic data of 79 patients harboring 79 aneurysms treated with TFD from the Parent Artery Reconstruction for Large or Giant Cerebral Aneurysms Using Tubridge (PARAT) trials were retrospectively collected and analyzed, in which 12 nationwide centers participated from December 2012 to May 2014. Digital subtraction angiography (DSA) was performed to evaluate immediate treatment results and coverage of branch vessels. For aneurysms treated by TFDs and coils, immediate results were classified according to Raymond Grade System, and for aneurysms treated by TFDs only, immediate results were evaluated according to stagnation of contrast. Angiographic follow-up was preformed conventionally after treatment with TFDs at 3 months using magnetic resonance angiography (MRA)and 6 months using DSA.
ResultsA total of 91 TFD were delivered and implanted successfully in the 79 lesions. Fifty-eight aneurysms were treated by TFDs and coils, and Raymond Ⅰwas achieved in 2 lesions (3.4%), Raymond Ⅱ in 5 lesions (8.6%) and Raymond Ⅲ in 51 lesions (87.9%). For 21 aneurysms treated by TFDs alone, stagnation of contrast was observed in 15 lesions (71.4%). One hundred and ten branch arteries were covered by TFDs. MRA was available in 52 patients at 3 months, and 31 lesions (59.6%) were completed cured, 16 lesions (30.8%) were improved and 5 lesions (9.6%) remained stable. DSA data were available in 73 patients at 6 months. Among them, 55 (75.3%) were completed cured, 14 (19.2%) were improved, 2 (2.7%) remained stable and 2 (2.7%) developed recurrence. The total rate of effective treatment (completely cured and improved) was 94.5% (69/73). Branch artery occlusion was observed in 3 cases, including 1 anterior choroidal artery, 1 anterior cerebral artery and 1 ophthalmic artery, without permanent neurologic deficits. The occlusion rate of branch arteries was 2.9% (3/104).
ConclusionBranch arteries covered by Tubridge flow diverter in treatment of intracranial aneurysms seem relatively safe and further clinical follow-up is needed.
Key words:
Intracranial aneurysm; Flow diverter; Safety
Contributor Information
Fang Yibin
Department of Neurosurgery, Changhai Hospital, Navy Medical University, Shanghai 200433, China
Lyu Nan
Zhou Yu
Wu Yi′na
Zhao Rui
Li Qiang
Yang Pengfei
Huang Qinghai
Hong Bo
Xu Yi
Liu Jianmin
