The Journal of Practical Medicine >

2026 , Vol. 42 >Issue 11: 1889 - 1898

DOI: https://doi.org/10.3969/j.issn.1006-5725.2026.11.001

Cardiovascular and Cerebrovascular Diseases Column

Arterial diameter difference in predicting in-stent stenosis for intracranial aneurysms after flow-diversion treatment

  • Chi HUANG ,
  • Xuetao WANG ,
  • Danyu ZHANG ,
  • Zhouxian ZHANG ,
  • Weijia HUANG ,
  • Chao PENG ,
  • Zongduo GUO ,
  • Shuyin LIANG ,
  • Xin FENG ,
  • Xin ZHANG ,
  • Xifeng LI ,
  • Aihua LIU ,
  • Chuanzhi DUAN ,
  • Shixing SU
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  • 1.Neurosurgery Center，Department of Cerebrovascular Surgery，the National Key Clinical Specialty，Engineering Research Center of Diagnostic and Therapeutic Technology and Devices for Cerebrovascular Diseases in Ministry of Education，Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration，Zhujiang Hospital Institute for Brain Science and Intelligence，Zhujiang Hospital，Southern Medical University，Guangzhou 510282，Guangdong，China
    2.Department of Neurosurgery，Zhongshan Hospital of Traditional Chinese Medicine，Zhongshan 528403，Guangdong，China
    3.The First School of Clinical Medicine，Southern Medical University，Guangzhou 510000，Guangdong，China
    4.The Second School of Clinical Medicine，Southern Medical University，Guangzhou 510000，Guangdong，China
    5.Department of Neurosurgery，the Third Affiliated Hospital of Southern Medical University，Guangzhou 510000，Guangdong，China
    6.Department of Neurosurgery，Guangdong Provincial People's Hospital，Guangzhou 510080，Guangdong，China
    7.Department of Neurosurgery，the First Affiliated Hospital of Chongqing Medical University，Chongqing 400016，Chongqing，China
    8.Department of Interventional Neuroradiology，Beijing Neurosurgical Institute，Beijing Tiantan Hospital，Capital Medical University，Beijing 100070，Beijing，China

Received date: 2026-01-20

  Online published: 2026-06-15

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Abstract

Objective To investigate the association between arterial diameter discrepancy （ADD） and the incidence of in-stent stenosis （ISS） following flow diverter （FD） placement. Methods This retrospective analysis utilized data from a prospectively maintained multicenter registry across six advanced stroke centers in China. Patients who underwent FD treatment with the Pipeline Embolization Device （PED） or Tubridge Flow Diverter （TFD） between January 2020 and January 2024 were enrolled. Multivariable logistic regression models with progressive covariate adjustment and restricted cubic spline （RCS） analyses were used to evaluate the association between ADD and ISS at the 6-month angiographic follow-up. Sensitivity analyses assessed significant ISS as a secondary outcome. Subgroup analyses were performed to determine whether the association varied across patient characteristics. Results A total of 439 patients were included （53.5 ± 10.5） years. At the 6-month follow-up， the rates of complete aneurysm occlusion and ISS were 81.8% and 15.0%， respectively. Multivariable analysis revealed that each unit increase in ADD was associated with a 2.4-fold increase in the odds of ISS （OR = 2.42， 95% CI： 1.53 ~ 3.82， P < 0.001）. These findings remained robust in sensitivity analyses. Subgroup analyses showed no significant effect modification across patient characteristics. RCS analysis demonstrated a threshold effect， with the risk of both ISS and significant ISS increasing markedly when ADD exceeded 0.30. Conclusions Higher arterial diameter discrepancy is independently associated with an increased risk of ISS following FD placement. These findings may aid neurointerventionalists in preprocedural risk stratification and device selection， highlighting the potential clinical value of tapered FDs for treating vessels with significant diameter mismatches.

Key words： intracranial aneurysm; flow-diverter devices; in-stent stenosis; endovascular treatment; risk factors

Cite this article

Chi HUANG , Xuetao WANG , Danyu ZHANG , Zhouxian ZHANG , Weijia HUANG , Chao PENG , Zongduo GUO , Shuyin LIANG , Xin FENG , Xin ZHANG , Xifeng LI , Aihua LIU , Chuanzhi DUAN , Shixing SU . Arterial diameter difference in predicting in-stent stenosis for intracranial aneurysms after flow-diversion treatment[J]. The Journal of Practical Medicine, 2026 , 42(11) : 1889 -1898 . DOI: 10.3969/j.issn.1006-5725.2026.11.001

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