Comparison of Pipeline embolization device versus Tubridge embolization device in unruptured intracranial aneurysms: a multicenter, propensity score matched study.

Aneurysm Flow Diverter Vascular Malformation

Journal

Journal of neurointerventional surgery
ISSN: 1759-8486
Titre abrégé: J Neurointerv Surg
Pays: England
ID NLM: 101517079

Informations de publication

Date de publication:
06 May 2024
Historique:
received: 22 02 2024
accepted: 18 04 2024
medline: 9 5 2024
pubmed: 9 5 2024
entrez: 8 5 2024
Statut: aheadofprint

Résumé

Flow diverter devices (FDs) are increasingly used for treating unruptured intracranial aneurysms (UIAs), but limited studies compared different FDs. To conduct a propensity score matched analysis comparing the Pipeline embolization device (PED) and Tubridge embolization device (TED) for UIAs. Patients with UIAs treated with either PED or TED between July 2016 and July 2022 were included. Propensity score matching was performed to adjust for age, sex, comorbidities, smoking, drinking, aneurysm size, morphology, neck, location, parent artery diameter, adjunctive coiling, and angiographic follow-up duration. Perioperative complications and clinical and angiographic outcomes were compared after matching. 735 patients treated by PED and 290 patients treated by TED were enrolled. Compared with the PED group, patients in the TED group had a greater number of women and patients with ischemia, a smaller proportion of vertebrobasilar and non-saccular aneurysms, a smaller size and neck, and fewer adjunctive coils and overlapping stents, but a larger parent artery diameter and lumen disparities. After adjusting for these differences, 275 pairs were matched. No differences were found in perioperative complications (4.4% vs 2.5%, P=0.350), in-stent stenosis (16.0% vs 15.6%, P>0.999), or favorable prognosis (98.9% vs 98.5%, P>0.999). However, PED showed a trend towards better complete occlusion over a median 8-month angiographic follow-up (81.8% vs 75.3%, P=0.077). Compared with PED, TED provides a comparable rate of perioperative and short-term outcomes. Nevertheless, a better occlusion status in the PED group needs to be further verified over a longer follow-up period.

Sections du résumé

BACKGROUND BACKGROUND
Flow diverter devices (FDs) are increasingly used for treating unruptured intracranial aneurysms (UIAs), but limited studies compared different FDs.
OBJECTIVE OBJECTIVE
To conduct a propensity score matched analysis comparing the Pipeline embolization device (PED) and Tubridge embolization device (TED) for UIAs.
METHODS METHODS
Patients with UIAs treated with either PED or TED between July 2016 and July 2022 were included. Propensity score matching was performed to adjust for age, sex, comorbidities, smoking, drinking, aneurysm size, morphology, neck, location, parent artery diameter, adjunctive coiling, and angiographic follow-up duration. Perioperative complications and clinical and angiographic outcomes were compared after matching.
RESULTS RESULTS
735 patients treated by PED and 290 patients treated by TED were enrolled. Compared with the PED group, patients in the TED group had a greater number of women and patients with ischemia, a smaller proportion of vertebrobasilar and non-saccular aneurysms, a smaller size and neck, and fewer adjunctive coils and overlapping stents, but a larger parent artery diameter and lumen disparities. After adjusting for these differences, 275 pairs were matched. No differences were found in perioperative complications (4.4% vs 2.5%, P=0.350), in-stent stenosis (16.0% vs 15.6%, P>0.999), or favorable prognosis (98.9% vs 98.5%, P>0.999). However, PED showed a trend towards better complete occlusion over a median 8-month angiographic follow-up (81.8% vs 75.3%, P=0.077).
CONCLUSION CONCLUSIONS
Compared with PED, TED provides a comparable rate of perioperative and short-term outcomes. Nevertheless, a better occlusion status in the PED group needs to be further verified over a longer follow-up period.

Identifiants

pubmed: 38719444
pii: jnis-2024-021623
doi: 10.1136/jnis-2024-021623
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Chi Huang (C)

Neurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China.

Gengwu Ma (G)

Neurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China.

Xin Tong (X)

Neurointervention Center, Beijing Neurosurgical Institute, Beijing, Beijing, China.
Neurointervention Center, Beijing Tiantan Hospital, Beijing, Beijing, China.

Xin Feng (X)

Neurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China.

Zhuohua Wen (Z)

Neurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China.

Mengshi Huang (M)

Neurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China.

Anqi Xu (A)

Neurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China.

Hao Yuan (H)

Neurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China.

HongYu Shi (H)

Neurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China.

Jiancheng Lin (J)

Neurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China.

Can Li (C)

Neurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China.

Runze Ge (R)

Neurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China.

Jiwan Huang (J)

Neurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China.

Chao Peng (C)

Department of Neurosurgery, Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China.

Yajun Zhu (Y)

Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, China.

Tao Wang (T)

Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Southwest Medical University, Luzhou, Sichuan, China.

Changren Huang (C)

Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Southwest Medical University, Luzhou, Sichuan, China.

Zongduo Guo (Z)

Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, China.

Shuyin Liang (S)

Neurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China.

Shixing Su (S)

Neurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China.

Xin Zhang (X)

Neurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China.

Xifeng Li (X)

Neurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China.

Aihua Liu (A)

Neurointervention Center, Beijing Neurosurgical Institute, Beijing, Beijing, China doctor_duanZJ@163.com liuaihuadoctor@163.com.
Neurointervention Center, Beijing Tiantan Hospital, Beijing, Beijing, China.

Chuan-Zhi Duan (CZ)

Neurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China doctor_duanZJ@163.com liuaihuadoctor@163.com.

Classifications MeSH