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ORIGINAL RESEARCH article
Front. Neurol.
Sec. Endovascular and Interventional Neurology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1552610
This article is part of the Research Topic Advances in the Understanding, Diagnosis, and Management of Intracranial and Extracranial Arterial Dissections View all 4 articles
Tubridge flow diverter for the treatment of dissecting aneurysms in middle cerebral artery
Provisionally accepted- 1 Huadong Hospital, Fudan University, Shanghai, China
- 2 Naval Medical University, Shanghai, Shanghai, China
Background: Tubridge flow diverter (TFD) has become a widely used device for reconstructing parent vessels and sealing complicate aneurysms in China. However, its application in managing distal small to medium-sized dissecting aneurysms has not been extensively investigated. This study aimed to evaluate the safety and effectiveness and factors affecting healing of the TFD for those dissecting aneurysms in middle cerebral artery (MCA).Methods: Those patients with dissecting aneurysms in MCA who were treated with TFD from 2019 to 2023 were included. According to O'Kelly-Marotta Scale (OKM), The OKM A grade was defined as dense embolism, and OKM B to OKM D was defined as non-dense embolism in this study. Clinical information, the degree of aneurysm occlusion, and the clinical outcomes were retrospectively analyzed.Results: Twenty-five patients with 25 MCA dissecting aneurysms were identified. The average age was 52.4 years (age range 20-76), with five patients (20%) suffering from subarachnoid hemorrhage. Twelve aneurysms were located in the M1 segment, eleven involved in M2 bifurcation, and two were in the M3 or above. The median aneurysm length was 17.3 mm (range 4.2-27) and the average width was 5.4 mm (range 2.3-7.6). Twelve cases had one or more branches in MCA. Four cases (16%) showed asymptomatic in-stent stenosis, and five cases (20%) showed the main branch injured during angiographic follow-up. Three patients suffered from acute ischemic events, and one had not recovered totally during follow-up and there was no death case related procedure-complication. According to single-factor analysis, the patients in non-dense embolism group during follow-up had more strong branches before operation (χ 2 =9.001, P=0.003).TFD is a safe and effective flow diverter for distal dissecting MCA aneurysms.Those aneurysms with strong branches had a higher rate of non-dense embolism during follow-up.
Keywords: Dissecting aneurysms, Flow diverter, Middle Cerebral Artery, branches, stent
Received: 28 Dec 2024; Accepted: 03 Mar 2025.
Copyright: © 2025 Yu, Li, Huang, Shen, Xu, Li and Dai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Dongwei Dai, Huadong Hospital, Fudan University, Shanghai, China
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