Article Figures & Data
Figures
- Fig 1.
Right internal carotid artery digital subtraction angiography (A) revealed a 13-mm wide-neck cavernous segment aneurysm. A Tubridge flow diverter was deployed into the parent artery, aimed at covering the aneurysmal neck, but postoperative DynaCT revealed that the flow diverter was not fully opened (B, white arrow). Cross-sectional image (C, white arrow) and 3D reconstruction (D, white arrow) show poor opening of the device. Fortunately, 18-month follow-up angiography reveals that the aneurysm is stable with a patent artery (E).
- Fig 2.
Right internal carotid artery digital subtraction angiography and 3D reconstruction (A–C) reveal a giant cavernous segment aneurysm of approximately 25.3 mm. The microcatheter is delivered across the aneurysmal neck (D), and 1 Tubridge flow diverter is deployed. Postoperative angiography reveals a disrupted inflow jet, slow flow, and flow reduction (E and F). The 23-month follow-up angiography reveals that the aneurysm is completely occluded (G). H, The black arrow points to the patent covered ophthalmic artery during follow-up compared with the preoperative image. MR imaging follow-up shows shrinkage of the aneurysm (black arrow).
- Fig 3.
Left internal carotid artery digital subtraction angiography of an aneurysm treated with a Tubridge flow diverter combined with coils, which results in partial occlusion of the aneurysm (A). DynaCT reconstruction reveals full opening of the flow diverter (B).The 18-month follow-up angiography reveals that the aneurysm has improved, and only a neck remnant is observed (C, black arrow).
Tables
- Table 1:
Clinical, angiographic, and follow-up data in 28 patients with 28 large or giant ICA aneurysms
Characteristics Patients (aneurysms) (No.) 28 (28) Mean age (range) (yr) 54.8 (20–73) Male/female 8:20 Aneurysm location ICA communicating 2 ICA ophthalmic 8 ICA paraclinoid 7 ICA cavernous 10 ICA petrous 1 Presentation Asymptomatic 6 Headache 11 Recanalization 3 Oculomotor paralysis 7 Blurred vision 3 Blind 1 Amenorrhea 1 Aneurysm size Large (10–15 mm) 4 Very large (15–25 mm) 16 Giant (≥25 mm) 8 - Table 2:
Clinical, angiographic, and follow-up data in 28 patients with 28 large or giant ICA aneurysms
Treatment Treatment strategy FD alone 10 FD + loose coiling 18 No. implanted flow diverters Two overlapping flow diverters 5 Single flow diverter 23 Technique adverse event Poor midstent opening 1 Immediate angiographic results Partial occlusion 16 Neck remnant 2 Disrupted inflow jet and slow flow 9 Flow reduction 7 No change 3 Clinical symptoms Resolved 13 Improved 6 No change 4 Transient worsening 5 Overall procedure-related morbidity/mortality 0/0 Follow-up angiographic results (n = 25) Complete occlusion 18 (72%) Improvement 6 (24%) Stable 1 (4%) FD Alone FD Plus Coiling Total Complete occlusion 6 (75.0%) 12 (70.5%) 18 (72.0%) Improved to neck remnant 1 (12.5%) 5 (29.4%) 6 (24.0%) Unchanged 1 (12.5%) 0 1 (2.0%) Total 8 17 25 Type Size (mm) Braided Microfilamentsa Radio-Opaque Microfilaments Flared End Metal Coverage Retrievable No. Material Pipeline 3–5.5 48 75% Cobalt chromium and 25% platinum NA No 30%–35% Nob Silk 2.5–5 48 Nickel-titanium alloy 4 Platinum wires Yes 35%–55% Yes Surpass 2.5–5 2.5 mm, 36; 3 and 4 mm, 60; 5 mm, 84 Cobalt-chromium 12 Platinum wires No 30% NA Tubridge 2.5–6.5 <3.5 mm, 46; ≥3.5 mm, 62 Nickel-titanium alloy 2 Platinum-iridium wires Yes 30%–35% Yes
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