Tubridge flow diverter for the treatment of large and giant cavernous carotid aneurysms: a long-term follow-up study

Abstract

Objective To evaluate the safety and efficacy of Tubridge blood flow diverter (FD) in the treatment of large and giant cavernous carotid aneurysms. Methods The clinical and angiographic data of 27 patients harboring 27 large or giant cavernous carotid aneurysms and treated between November 2010 and December 2014 at Department of Neurosurgery, Clinical Neuroscience Center, Changhai Hospital, Second Military Medical University, were prospectively collected and analyzed. Among them, 16 aneurysms were treated with Tubridge FD combined with coil embolization, while the other 11 were treated with merely Tubridge FDs. Tubridge FDs were employed in all those cases, which were postoperatively followed up in clinics or by telephone to document the patients' symptomatic improvement and imaging results. Results A total of 38 Tubridge FDs were successfully implanted for the 27 aneurysms. During the follow-up lasting from 27 to 76 months (mean: 49.8±15.4 months), clinical symptoms were resolved in 15 out of 26 patients, improved in 5, and unchanged in 6. In total, the rate of symptomatic relief was 77% (20/26). Procedure-related morbidity and mortality were both 0. Follow-up angiographies, with a mean follow-up period of 22.8±13.1 (6-48 months), were available in 25 aneurysms. Complete occlusion was observed in 20/25 (80%) aneurysms, further thrombosis was reported in 4/25(16%) cases, and non-symptomatic parent artery occlusion was reported in(1/25, 4%). All stent-associated branches were patent. Conclusion It is suggested that Tubridge FD is a safe and effective tool for treatment of large and giant cavernous carotid aneurysms with high resolving rate of compression symptoms. Key words: Intracranial aneurysm; Embolization, therapeutic; Cavernous segment of internal carotid artery; Flow diverter; Long-term effects