Skip to main content
SpringerLink
Log in

Long-Term Outcome of Tubridge Flow Diverter(S) in Treating Large Vertebral Artery Dissecting Aneurysms—A Pilot Study

  • Original Article
  • Published:
Clinical Neuroradiology Aims and scope Submit manuscript

Abstract

Background and Purpose

The experience of flow diverters (FDs) in treating large vertebral artery-dissecting aneurysms (VADAs) is still limited. This study was conducted to present our long-term outcome of VADAs treated with a Tubridge flow diverter (TFD), a new device developed in China.

Materials and Methods

The clinical and angiographic data of six patients harboring large VADAs and treated with TFDs were prospectively collected and analyzed.

Results

A total of nine TFDs were successfully implanted in six patients. Angiographic follow-up images were available for all patients at a median of 26.0 (18.5, 37.5) months after treatment. Five of the six VADAs were completely occluded, and the last was improved (near complete occlusion). In-stent stenosis was detected in one case and was handled appropriately by angioplasty and stenting. All covered branches and parent arteries remained patent. There were no complications or new neurological deficits observed in any of the patients. At the latest clinical follow-up (36.5 (26.0, 44.5) months), all patients achieved 0 in the modified Rankin scale score.

Conclusions

Our preliminary experience suggests that the Tubridge flow diverter might be an alternative treatment for large and recurrent dissecting aneurysms derived from the vertebral artery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Mizutani T, Aruga T, Kirino T, Miki Y, Saito I, Tsuchida T. Recurrent subarachnoid hemorrhage from untreated ruptured vertebrobasilar dissecting aneurysms. Neurosurgery. 1995;36(5):905–11; discussion 912–3.

    Article  CAS  PubMed  Google Scholar 

  2. Yoshimoto Y, Wakai S. Unruptured intracranial vertebral artery dissection. Clinical course and serial radiographic imagings. Stroke. 1997;28(2):370–4.

    Article  CAS  PubMed  Google Scholar 

  3. Fukasawa I, Sasaki H, Nukui H. Surgical treatment for ruptured vertebral artery dissecting aneurysms. Neurol Med Chir (Tokyo). 1998;38(Suppl):104–6.

    Article  Google Scholar 

  4. Iihara K, Sakai N, Murao K, Sakai H, Higashi T, Kogure S, Takahashi JC, Nagata I. Dissecting aneurysms of the vertebral artery: a management strategy. J Neurosurg. 2002;97(2):259–67.

    Article  PubMed  Google Scholar 

  5. Albuquerque FC, Park MS, Abla AA, Crowley RW, Ducruet AF, McDougall CG. A reappraisal of the Pipeline embolization device for the treatment of posterior circulation aneurysms. J Neurointerv Surg. 2015;7(9):641–5.

    Article  PubMed  Google Scholar 

  6. Murthy SB, Shah S, Shastri A, Venkatasubba RC, Bershad EM, Suarez JI. The SILK flow diverter in the treatment of intracranial aneurysms. J Clin Neurosci. 2014;21(2):203–6.

    Article  PubMed  Google Scholar 

  7. Monteith SJ, Tsimpas A, Dumont AS, Tjoumakaris S, Gonzalez LF, Rosenwasser RH, Jabbour P. Endovascular treatment of fusiform cerebral aneurysms with the Pipeline Embolization Device. J Neurosurg. 2014;120(4):945–54.

    Article  PubMed  Google Scholar 

  8. Zhou Y, Yang PF, Fang YB, Xu Y, Hong B, Zhao WY, Li Q, Zhao R, Huang QH, Liu JM. A novel flow-diverting device (Tubridge) for the treatment of 28 large or giant intracranial aneurysms: a single-center experience. AJNR Am J Neuroradiol. 2014;35(12):2326–33.

    Article  CAS  PubMed  Google Scholar 

  9. O’Kelly CJ, Krings T, Fiorella D, Marotta TR. A novel grading scale for the angiographic assessment of intracranial aneurysms treated using flow diverting stents. Interv Neuroradiol. 2010;16(2):133–7.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Zhao KJ, Zhao R, Huang QH, Xu Y, Hong B, Fang YB, Li Q, Yang PF, Liu JM, Zhao WY. The interaction between stent(s) implantation, PICA involvement, and immediate occlusion degree affect symptomatic intracranial spontaneous vertebral artery dissection aneurysm (sis-VADA) recurrence after reconstructive treatment with stent(s)-assisted coiling. Eur Radiol. 2014;24(9):2088–96.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Ertl L, Holtmannspötter M, Patzig M, Brückmann H, Fesl G. Use of flow-diverting devices in fusiform vertebrobasilar giant aneurysms: a report on periprocedural course and long-term follow-up. AJNR Am J Neuroradiol. 2014;35(7):1346–52.

    Article  CAS  PubMed  Google Scholar 

  12. Brinjikji W, Murad MH, Lanzino G, Cloft HJ, Kallmes DF. Endovascular treatment of intracranial aneurysms with flow diverters: a meta-analysis. Stroke. 2013;44(2):442–7.

    Article  PubMed  Google Scholar 

  13. Zhao KJ, Fang YB, Huang QH, Xu Y, Hong B, Li Q, Liu JM, Zhao WY, Deng BQ. Reconstructive treatment of ruptured intracranial spontaneous vertebral artery dissection aneurysms: long-term results and predictors of unfavorable outcomes. PLoS One. 2013;8(6):e67169.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Song Y, Wang Y, Li C, Wang Y, Mu S, Yang X. Retreatment and outcomes of recurrent intracranial vertebral artery dissecting aneurysms after stent assisted coiling: a single center experience. PLoS One. 2014;9(11):e113027.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Darsaut TE, Rayner-Hartley E, Makoyeva A, Salazkin I, Berthelet F, Raymond J. Aneurysm rupture after endovascular flow diversion: the possible role of persistent flows through the transition zone associated with device deformation. Interv Neuroradiol. 2013;19(2):180–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Zhou Y, Yang PF, Fang YB, Xu Y, Hong B, Zhao WY, Li Q, Zhao R, Huang QH, Liu JM. Parent artery reconstruction for large or giant cerebral aneurysms using a Tubridge flow diverter (PARAT): study protocol for a multicenter, randomized, controlled clinical trial. BMC Neurol. 2014;14:97.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Kallmes DF, Hanel R, Lopes D, Boccardi E, Bonafe A, Cekirge S, Fiorella D, Jabbour P, Levy E, McDougall C, Siddiqui A, Szikora I, Woo H, Albuquerque F, Bozorgchami H, Dashti SR, Delgado Almandoz JE, Kelly ME, Turner R 4th, Woodward BK, Brinjikji W, Lanzino G, Lylyk P. International retrospective study of the pipeline embolization device: a multicenter aneurysm treatment study. AJNR Am J Neuroradiol. 2015;36(1):108–15.

    Article  CAS  PubMed  Google Scholar 

  18. Meckel S, McAuliffe W, Fiorella D, Taschner CA, Phatouros C, Phillips TJ, Vasak P, Schumacher M, Klisch J. Endovascular treatment of complex aneurysms at the vertebrobasilar junction with flow-diverting stents: initial experience. Neurosurgery. 2013;73(3):386–94.

    Article  PubMed  Google Scholar 

  19. Cohen JE, Gomori JM, Moscovici S, Leker RR, Itshayek E. Delayed complications after flow-diverter stenting: reactive in-stent stenosis and creeping stents. J Clin Neurosci. 2014;21(7):1116–22.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by the National Sci-tech Support Plan grant number [2011BAI08B14] Shanghai Science and Technology Development Funds grant number [14441904702], National Natural Science Foundation of China grant number [81301004, 81471189] and Shanghai Science and Technology Development Funds grant number [13140903201].

Conflict of Interest

The other authors declared they have no competing interests.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Changhai Hospital, Second Military Medical University, 200433, Yangpu District, Shanghai, No.168 Changhai Road, China

    Y.-B. Fang, W.-L. Wen, P.-F. Yang, Y. Zhou, Y.-N. Wu, B. Hong, Y. Xu, W.-Y. Zhao, J.-M. Liu & Q.-H. Huang

Authors
  1. Y.-B. Fang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. W.-L. Wen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P.-F. Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Y. Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Y.-N. Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. B. Hong
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Y. Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. W.-Y. Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. J.-M. Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Q.-H. Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to J.-M. Liu or Q.-H. Huang.

Additional information

Yibin Fang and Wanling Wen are co-first authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fang, YB., Wen, WL., Yang, PF. et al. Long-Term Outcome of Tubridge Flow Diverter(S) in Treating Large Vertebral Artery Dissecting Aneurysms—A Pilot Study. Clin Neuroradiol 27, 345–350 (2017). https://doi.org/10.1007/s00062-015-0494-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00062-015-0494-8

Keywords

Search

Navigation