Pipeline versus Tubridge in the treatment of unruptured posterior circulation aneurysms

Background To compare the safety and efficacy of pipeline embolization device(PED)and Tubridge flow diverter(TFD)for unruptured posterior circulation aneurysms.Methods Posterior aneurysm patients treated with PED or TFD between January,2019,and December,2021,were retrospectively reviewed.Patients’demographics,aneurysm characteristics,treatment details,complications,and follow-up information were collected.The procedural-related complications and angiographic and clinical outcome were compared.Results A total of 107 patients were involved;PED was applied for 55 patients and TFD for 52 patients.A total of 9(8.4%)procedural-related complications occurred,including 4(7.3%)in PED group and 5(9.6%)in TFD group.During a mean of 10.3-month angiographic follow-up for 81 patients,complete occlusion was achieved in 35(85.4%)patients in PED group and 30(75.0%)in TFD group.The occlusion rate of PED group is slightly higher than that of TFD group.A mean of 25.0-month clinical follow-up for 107 patients showed that favorable clinical outcome was achieved in 53(96.4%)patients in PED group and 50(96.2%)patients in TFD group,respectively.No statistical difference was found in terms of procedural-related complications(p=0.737),occlusion rate(p=0.241),and favorable clinical outcome(0.954)between groups.Conclusions The current study found no difference in complication,occlusion,and clinical outcome between PED and TFD for unruptured PCAs.

Giant serpentine aneurysm of the internal cerebral artery and mandibular aneurysm: a case report

Background:Giant serpentine aneurysms(GSA)originate from saccular or spindle aneurysm,dissimilar from dissected aneurysm,that are defined as partially thrombosed giant aneurysms with tortuous internal vascular channel.The clinical and neuroradiologic characteristics are clarified and the mechanism of formation and the efficacy of double stent implantation in GSA are discussed.Case presentation:An 18-year-old man presented himself with a GSA arising from the internal cerebral artery(ICA).In addition,a mandibular aneurysm(MA)arose from the external cerebral artery(ECA).Success was achieved in treating GSA through endovascular treatment with double stents implanted in the parent artery,which were LEO stent and Tubridge flow diverter.After 1 year of follow-up,three-dimensional reconstruction of blood vessels revealed the disappearance of the serpentine access of GSA,which was found to be replaced with a roughly normal vascular structure.Conclusions:Double stent implantation has provided a feasible treatment option for giant serpentine internal carotid aneurysms and eliminated the possibility of causing collateral circulation occlusion.Therefore,it represents a simple and suitable treatment method for anatomical structure and operation.