Efficacy and safety of flow diverter implantation versus stent-assisted coil embolization in unruptured saccular aneurysms located at distal segments of the Willis circle
10.3760/cma.j.cn115354-20250914-00555
- VernacularTitle:血流导向装置植入与支架辅助弹簧圈栓塞治疗Willis环远端未破裂囊状动脉瘤的有效性及安全性差异
- Author:
Peifeng GUAN
1
;
Lunzhe YANG
;
Xiangbin WANG
;
Yilin LIU
;
Xingqiao YANG
;
Runze GE
;
Hui JIANG
;
Chuanzhi DUAN
;
Guangzhong CHEN
Author Information
1. 南方医科大学附属广东省人民医院（广东省医学科学院）神经外科，广州 510080
- Publication Type:Journal Article
- Keywords:
Intracranial aneurysm;
Willis circle;
Distal aneurysm;
Flow diverter;
Stent-assisted coil embolization;
Propensity score matching
- From:
Chinese Journal of Neuromedicine
2025;24(11):1107-1114
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacy and safety of flow diverter (FD) implantation versus stent-assisted coil embolization (SACE) in unruptured saccular aneurysms located at distal segments of the Willis circle.Methods:A retrospective study was performed; 119 patients with unruptured saccular aneurysms located at distal segments of the Willis circle who received FD implantation or SACE in Department of Neurosurgery, Guangdong Provincial People's Hospital, Southern Medical University and Department of Cerebrovascular Surgery, Neurosurgery Center, Southern Medical University from January 2018 to May 2025 were selected. According to different surgical methods, they were divided into a FD group ( n=60) and a SACE group ( n=59). These patients were subjected to propensity score matching (PSM) using 1:1 nearest neighbor matching method to eliminate confounding factors such as gender, age, aneurysm location, and aneurysm diameter (maximum diameter); and then, differences in neurological functional prognosis (good prognosis: modified Rankin scale scores of 0-2), complete aneurysm occlusion rate (O'Kelly-Marotta grade D or Raymond occlusion classification class I), and overall (perioperative and follow-up) complications were compared between the two groups. Results:After PSM, there were 43 patients in both FD group and SACE group. No significant difference was found in clinical and imaging follow-ups (12[6, 19] months vs. 10[6, 15] months, 10[5, 19] months vs. 9[2, 15] months) between the FD group and SACE group ( P>0.05). At the last imaging follow-up, the complete aneurysm occlusion rate in the FD group (65.1%[28/43]) was significantly lower than that in the SACE group (76.7%[33/43], P<0.05). At the last clinical follow-up, no significant difference was noted in good prognosis rate (95.3%[41/43] vs. 97.7%[42/43]) and overall complication rate (30.2%[13/43] vs. 18.6%[8/43]) between the FD group and SACE group ( P>0.05). Conclusion:Both FD implantation and SACE are safe and effective for unruptured saccular aneurysms located at distal segments of the Willis circle; the complete aneurysm occlusion rate within 1 year of FD implantation is relatively low.
