Flow diverter braid deformation occurred in 17.3% of patients treated with non-DFT wire devices, representing a benign morphological change independently predicted by younger age and proximal stent oversizing.
Observational (n=139)
No
What is the incidence and clinical significance of flow diverter braid deformation following treatment with non-DFT wire devices for intracranial aneurysms?
Flow diverter braid deformation in non-DFT wire devices is relatively common but typically represents a benign and stable morphological change without adverse clinical outcomes.
Flow diverter braid deformation is occasionally observed after flow diverter placement. However, the frequency and clinical significance of flow diverter braid deformation in non-drawn filled tube wire devices remain unclear. This retrospective, single-center study analyzed 139 consecutive patients (median age, 60 years; 82.7% women) who underwent flow diverter placement for intracranial aneurysms between 2017 and 2024. Follow-up angiography and cone-beam computed tomography images were compared with those obtained immediately after flow diverter deployment to identify flow diverter-related morphologic changes. The identified morphologic changes were classified into 4 major patterns (fish mouthing, bump, collapse, and shortening) as flow diverter braid deformation and 2 variants (distal tapering and edge flare) as minor morphologic changes. Cases with fish mouthing or collapse were classified as a high-risk flow diverter braid deformation category because of their association with thromboembolic complications. Flow diverter-related morphologic changes were detected in 31 patients (22.3%), including flow diverter braid deformation in 24 patients (17.3%), at the first angiographic follow-up, and no progression was detected during subsequent observations. The most common pattern was shortening (12.9%), followed by distal tapering (5.0%), and high-risk flow diverter braid deformation was rare (fish mouthing, 1.4%; collapse, 1.4%). Neointimal hyperplasia was more frequent in the flow diverter braid deformation group, whereas the rates of in-stent stenosis, aneurysm occlusion (O'Kelly-Marotta grades C-D), retreatment, and favorable functional outcomes (modified Rankin Scale, 0-2) did not differ significantly between the groups. Younger age and proximal stent oversizing were independent predictors of flow diverter braid deformation. Given the rarity of the high-risk category and the absence of adverse outcomes, flow diverter braid deformation represents a benign and stable morphological change in non-drawn filled tube wire flow diverters.
Fujii et al. (Thu,) conducted a observational in Intracranial aneurysms (n=139). Non-DFT wire flow diverters was evaluated on Incidence of flow diverter braid deformation (FDBD). Flow diverter braid deformation occurred in 17.3% of patients treated with non-DFT wire devices, representing a benign morphological change independently predicted by younger age and proximal stent oversizing.