Abstract：
OBJECTIVE: Flow-diversion treatment for intracranial aneurysms has been associated with the development of in-stent stenosis (ISS) for unclear reasons. We assess whether the size of the stent relative to that of the vessel (the stent-to-vessel diameter ratio, or SVR) may be predictive of the development of ISS after treatment with flow diverters.
METHODS: We retrospectively reviewed patients with unruptured intracranial aneurysms who underwent flow-diversion treatment using either the Pipeline or Tubridge embolization device from September 2018 to September 2022. The relationship between SVR and ISS was analyzed. Multiple logistic regression models were used to determine the significant predictors.
RESULTS: A total of 458 patients with 481 aneurysms were included. In a mean angiographic follow-up of 10.73 ± 3.97 months, ISS was detected in 68 cases (14.1 %). After adjusting for candidate variables, a higher distal SVR (DSVR) was associated with an increased risk of ISS (adjusted odds ratio [aOR] = 3.420, 95 % confidence interval [CI] = 1.182 - 9.889, p = 0.023). We conducted a subgroup analysis of the two different flow diverters to assess the effects of their individual characteristics. Our results showed a significant association between the DSVR and the incidence of ISS in both the Pipeline (aOR = 4.033, 95 % CI = 1.156-14.072, p = 0.029) and Tubridge groups (aOR = 11.981, 95 % CI=1.005-142.774, p = 0.049).
CONCLUSIONS: A higher DSVR was associated with an increased risk of ISS. This may help neurointerventionalists select an appropriate stent size when conducting flow-diversion treatment for intracranial aneurysms.
METHODS: We retrospectively reviewed patients with unruptured intracranial aneurysms who underwent flow-diversion treatment using either the Pipeline or Tubridge embolization device from September 2018 to September 2022. The relationship between SVR and ISS was analyzed. Multiple logistic regression models were used to determine the significant predictors.
RESULTS: A total of 458 patients with 481 aneurysms were included. In a mean angiographic follow-up of 10.73 ± 3.97 months, ISS was detected in 68 cases (14.1 %). After adjusting for candidate variables, a higher distal SVR (DSVR) was associated with an increased risk of ISS (adjusted odds ratio [aOR] = 3.420, 95 % confidence interval [CI] = 1.182 - 9.889, p = 0.023). We conducted a subgroup analysis of the two different flow diverters to assess the effects of their individual characteristics. Our results showed a significant association between the DSVR and the incidence of ISS in both the Pipeline (aOR = 4.033, 95 % CI = 1.156-14.072, p = 0.029) and Tubridge groups (aOR = 11.981, 95 % CI=1.005-142.774, p = 0.049).
CONCLUSIONS: A higher DSVR was associated with an increased risk of ISS. This may help neurointerventionalists select an appropriate stent size when conducting flow-diversion treatment for intracranial aneurysms.
摘要：
目的：颅内动脉瘤的分流治疗与支架内狭窄（ISS）的发展有关，原因尚不清楚。我们评估支架的大小相对于血管的大小(支架与血管直径比，或SVR）可以预测用分流器治疗后ISS的发展。
方法：我们回顾性回顾了2018年9月至2022年9月使用Pipeline或Tubridge栓塞装置进行分流治疗的未破裂颅内动脉瘤患者。分析SVR与ISS的关系。使用多元逻辑回归模型来确定重要的预测因子。
结果：共纳入458例患者481个动脉瘤。在平均10.73±3.97个月的血管造影随访中，ISS检出68例(14.1%)。调整候选变量后，较高的远端SVR(DSVR)与ISS风险增加相关(校正比值比[aOR]=3.420,95%置信区间[CI]=1.182-9.889,p=0.023).我们对两种不同的分流器进行了亚组分析，以评估其各自特征的影响。我们的结果显示DSVR与ISS的发生率在管道（aOR=4.033，95％CI=1.156-14.072，p=0.029）和Tubridge组（aOR=11.981，95％CI=1.005-142.774，p=0.049）之间存在显着关联。
结论：较高的DSVR与ISS风险增加相关。这可能有助于神经介入医生在对颅内动脉瘤进行分流治疗时选择合适的支架尺寸。
方法：我们回顾性回顾了2018年9月至2022年9月使用Pipeline或Tubridge栓塞装置进行分流治疗的未破裂颅内动脉瘤患者。分析SVR与ISS的关系。使用多元逻辑回归模型来确定重要的预测因子。
结果：共纳入458例患者481个动脉瘤。在平均10.73±3.97个月的血管造影随访中，ISS检出68例(14.1%)。调整候选变量后，较高的远端SVR(DSVR)与ISS风险增加相关(校正比值比[aOR]=3.420,95%置信区间[CI]=1.182-9.889,p=0.023).我们对两种不同的分流器进行了亚组分析，以评估其各自特征的影响。我们的结果显示DSVR与ISS的发生率在管道（aOR=4.033，95％CI=1.156-14.072，p=0.029）和Tubridge组（aOR=11.981，95％CI=1.005-142.774，p=0.049）之间存在显着关联。
结论：较高的DSVR与ISS风险增加相关。这可能有助于神经介入医生在对颅内动脉瘤进行分流治疗时选择合适的支架尺寸。
