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Background <p>Stent-assisted coiling (SAC) and flow diverters (FDs) are common endovascular treatments for intracranial bifurcation aneurysms. However, studies comparing FDs and SAC were scarce. Thus, we performed a two-center, propensity score matched (PSM) cohort study to compare the FDs and SAC devices for intracranial bifurcation aneurysms.</p> Methods <p>Consecutive patients with intracranial bifurcation aneurysms were treated with FDs or SAC at two advanced stroke centers were enrolled in the study. Propensity score matching (PSM) was employed to adjust for demographic and aneurysm characteristics. The perioperative and midterm follow-up outcomes were compared between the two devices.</p> Results <p>A total of 131 patients with 131 intracranial bifurcation aneurysms were included. After PSM, 66 aneurysms treated with the FDs and SAC were matched (<i>n</i> = 33 in each group). At a median follow-up of 6–7 months, significant differences were observed in procedure time (105.00&#xa0;min vs. 155.00&#xa0;min, <i>p</i> &lt; 0.001), rate of complete aneurysm occlusion (60.6% vs. 93.9%, <i>p</i> = 0.001) between the FDs and SAC group. There were no statistical differences in total perioperative complications (3.0% vs. 9.1%, <i>p</i> = 0.302), in-stent stenosis (9.1% vs. 9.1%, <i>p</i> = 1.000), device-related challenges (3.0% vs. 6.1%, <i>p</i> = 0.555) and follow-up mRS score of 3–5 (3.0% vs. 3.0%, <i>p</i> = 1.000) between the FDs and SAC group.</p> Conclusion <p>Compared with SAC, FDs provide a comparable rate of perioperative and clinical outcomes in unruptured intracranial bifurcation aneurysms. Nevertheless, a better occlusion status in the SAC group needs to be further verified over a longer follow-up period.</p>

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Comparison of flow diverters versus stent-assisted coiling in unruptured anterior circulation bifurcation aneurysms: a two-center, propensity score matched study

  • 期刊论文

  • 发表日期：

    2026年1月30日

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  • Runze Ge,
  • Lele Dai,
  • Wenxin Chen,
  • Xin Feng,
  • Xiaowen Zhang,
  • Zhuohua Wen,
  • Chi Huang,
  • Jiwan Huang,
  • Anqi Xu,
  • Jiancheng Lin,
  • Mengshi Huang,
  • Hao Yuan,
  • Hongyu Shi,
  • Can Li,
  • Fengying Yuan,
  • Lichun Zhang,
  • Shuyin Liang,
  • Yiming Bi,
  • Shixing Su,
  • Xin Zhang,
  • Jing Li,
  • Xifeng Li,
  • Bin Luo,
  • Sheng Guan,
  • Chuanzhi Duan

摘要

Background

Stent-assisted coiling (SAC) and flow diverters (FDs) are common endovascular treatments for intracranial bifurcation aneurysms. However, studies comparing FDs and SAC were scarce. Thus, we performed a two-center, propensity score matched (PSM) cohort study to compare the FDs and SAC devices for intracranial bifurcation aneurysms.

Methods

Consecutive patients with intracranial bifurcation aneurysms were treated with FDs or SAC at two advanced stroke centers were enrolled in the study. Propensity score matching (PSM) was employed to adjust for demographic and aneurysm characteristics. The perioperative and midterm follow-up outcomes were compared between the two devices.

Results

A total of 131 patients with 131 intracranial bifurcation aneurysms were included. After PSM, 66 aneurysms treated with the FDs and SAC were matched (n = 33 in each group). At a median follow-up of 6–7 months, significant differences were observed in procedure time (105.00 min vs. 155.00 min, p < 0.001), rate of complete aneurysm occlusion (60.6% vs. 93.9%, p = 0.001) between the FDs and SAC group. There were no statistical differences in total perioperative complications (3.0% vs. 9.1%, p = 0.302), in-stent stenosis (9.1% vs. 9.1%, p = 1.000), device-related challenges (3.0% vs. 6.1%, p = 0.555) and follow-up mRS score of 3–5 (3.0% vs. 3.0%, p = 1.000) between the FDs and SAC group.

Conclusion

Compared with SAC, FDs provide a comparable rate of perioperative and clinical outcomes in unruptured intracranial bifurcation aneurysms. Nevertheless, a better occlusion status in the SAC group needs to be further verified over a longer follow-up period.