{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T14:29:39Z","timestamp":1776954579011,"version":"3.51.4"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,11,2]],"date-time":"2022-11-02T00:00:00Z","timestamp":1667347200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Treatment of vertebral artery fusiform aneurysms (VAFAs) is complex and controversial. This study aimed to compare the safety and efficacy between flow diverter and conventional stents in patients with VAFAs undergoing endovascular stent-alone treatment (SAT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty-six patients with 36 VAFAs who underwent SAT between January 2014 and December 2018 were retrospectively analyzed. Patient and aneurysm characteristics, procedural details, complications, and angiographic and clinical outcomes were compared between flow diverter stent patients (<jats:italic>n<\/jats:italic> = 22) and conventional stent patients (<jats:italic>n<\/jats:italic> = 14).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>More branches covered with stent were found in the conventional stent group (88.9 vs. 33.3%; <jats:italic>p<\/jats:italic> = 0.008). The number of stents placed was significantly higher in the conventional stent group (1.57 \u00b1 0.76 vs. 1.09 \u00b1 0.29; <jats:italic>p<\/jats:italic> = 0.016). The proportion of patients with significant or moderate stasis within the aneurysm immediately after stent placement was higher in the flow diverter stent group (95.5 vs. 57.1%; <jats:italic>p<\/jats:italic> = 0.004). The proportion of patients with complete obliteration or only a residual neck on follow-up angiography was significantly higher in the flow diverter stent group (86.3 vs 50.0%; <jats:italic>p<\/jats:italic> = 0.047). However, the incidence of parent artery stenosis or occlusion was also higher in the flow diverter stent group (27.3% vs. zero; <jats:italic>p<\/jats:italic> = 0.032). The rate of complications did not significantly differ between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>SAT was safe and effective in patients with VAFAs. Flow diverter stents are associated with a significantly better complete occlusion rate than conventional stents; however, they are also associated with an increased risk of parent artery stenosis.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2022.1012382","type":"journal-article","created":{"date-parts":[[2022,11,2]],"date-time":"2022-11-02T06:07:18Z","timestamp":1667369238000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Stent-alone treatment of unruptured vertebral artery fusiform aneurysms: A comparison of flow diverter and conventional stents"],"prefix":"10.3389","volume":"13","author":[{"given":"Wenqiang","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanmin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yapeng","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianzhi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yisen","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,11,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1227\/NEU.0b013e31821723f2","article-title":"Endovascular treatment of posterior circulation fusiform aneurysms: single-center experience in 31 patients","volume":"69","author":"Raphaeli","year":"2011","journal-title":"Neurosurgery."},{"key":"B2","doi-asserted-by":"publisher","first-page":"E14","DOI":"10.3171\/2017.3.FOCUS1748","article-title":"Endovascular management of fusiform aneurysms in the posterior circulation: the era of flow diversion","volume":"42","author":"Awad","year":"2017","journal-title":"Neurosurg Focus."},{"key":"B3","doi-asserted-by":"publisher","first-page":"898","DOI":"10.1056\/NEJM200103223441206","article-title":"Spontaneous dissection of the carotid and vertebral arteries","volume":"344","author":"Schievink","year":"2001","journal-title":"N Engl J Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"4838","DOI":"10.3892\/etm.2019.8128","article-title":"Endovascular treatment of vertebral artery dissecting aneurysm: A single-center experience","volume":"18","author":"Zhao","year":"2019","journal-title":"Exp Ther Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"118","DOI":"10.3174\/ajnr.A5452","article-title":"Hemodynamic changes caused by multiple stenting in vertebral artery fusiform aneurysms: a patient-specific computational fluid dynamics study","volume":"39","author":"Lv","year":"2018","journal-title":"AJNR Am J Neuroradiol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"45","DOI":"10.3171\/2015.12.JNS151716","article-title":"Application of parallel stent placement in the treatment of unruptured vertebrobasilar fusiform aneurysms","volume":"126","author":"Wang","year":"2017","journal-title":"J Neurosurg."},{"key":"B7","doi-asserted-by":"publisher","first-page":"e40","DOI":"10.1016\/j.wneu.2019.04.174","article-title":"Low-profile visualized intraluminal support stent-only technique for intracranial aneurysms-a report of 12 cases with midterm follow-up","volume":"129","author":"Liu","year":"2019","journal-title":"World Neurosurg."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1258","DOI":"10.3171\/2012.2.JNS111942","article-title":"Panacea or problem: flow diverters in the treatment of symptomatic large or giant fusiform vertebrobasilar aneurysms","volume":"116","author":"Siddiqui","year":"2012","journal-title":"J Neurosurg."},{"key":"B9","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1177\/159101991001600204","article-title":"A novel grading scale for the angiographic assessment of intracranial aneurysms treated using flow diverting stents","volume":"16","author":"O'kelly","year":"2010","journal-title":"Interv Neuroradiol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1894","DOI":"10.3171\/2020.4.JNS192838","article-title":"Treatment of posterior circulation fusiform aneurysms","volume":"134","author":"Church","year":"2020","journal-title":"J Neurosurg."},{"key":"B11","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1093\/neuros\/nyaa317","article-title":"Giant fusiform and dolichoectatic aneurysms of the basilar trunk and vertebrobasilar junction-clinicopathological and surgical outcome","volume":"88","author":"Nakatomi","year":"2020","journal-title":"Neurosurgery."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1293","DOI":"10.3174\/ajnr.A4360","article-title":"Deconstructive and reconstructive techniques in treatment of vertebrobasilar dissecting aneurysms: a systematic review and meta-analysis","volume":"36","author":"S\u00f6nmez","year":"2015","journal-title":"AJNR Am J Neuroradiol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1136\/neurintsurg-2013-010897","article-title":"Endovascular treatment of fusiform intracranial vertebral artery aneurysms using reconstructive techniques","volume":"6","author":"Dabus","year":"2014","journal-title":"J Neurointerv Surg."},{"key":"B14","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1177\/1591019919846616","article-title":"Endovascular reconstructive treatment using a fill-and-tunnel technique for a fusiform vertebral artery dissecting aneurysm with ipsilateral dominance","volume":"25","author":"Kyeung Ko","year":"2019","journal-title":"Interv Neuroradiol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1177\/1591019918824413","article-title":"Reconstructive endovascular treatment of the V4 segment of a vertebral artery dissecting aneurysm with the Willis covered stent: A retrospective study","volume":"25","author":"Xiang","year":"2019","journal-title":"Interv Neuroradiol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"S52","DOI":"10.4103\/0028-3886.178043","article-title":"Endovascular treatment of ruptured vertebrobasilar dissecting aneurysms: Review of 40 consecutive cases","volume":"64","author":"Zhang","year":"2016","journal-title":"Neurol India"},{"key":"B17","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.wneu.2016.11.118","article-title":"Triple stent therapy for the treatment of vertebral dissecting aneurysms: efficacy and safety","volume":"99","author":"Chung","year":"2017","journal-title":"World Neurosurg."},{"key":"B18","first-page":"1814","article-title":"Stent-within-a-stent technique for the treatment of dissecting vertebral artery aneurysms","volume":"24","author":"Mehta","year":"2003","journal-title":"AJNR Am J Neuroradiol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1198","DOI":"10.1007\/s13311-020-00990-8","article-title":"Pipeline embolization device for intracranial aneurysms in a large chinese cohort: complication risk factor analysis","volume":"18","author":"Kang","year":"2021","journal-title":"Neurotherapeutics."},{"key":"B20","doi-asserted-by":"publisher","first-page":"S76","DOI":"10.1093\/neuros\/nyz344","article-title":"Expanding the Indications for Flow Diversion: Treatment of Posterior Circulation Aneurysms","volume":"86","author":"Adeeb","year":"2020","journal-title":"Neurosurgery."},{"key":"B21","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1186\/s12967-016-0959-9","article-title":"Flow diverter effect of LVIS stent on cerebral aneurysm hemodynamics: a comparison with Enterprise stents and the Pipeline device","volume":"14","author":"Wang","year":"2016","journal-title":"J Transl Med."},{"key":"B22","doi-asserted-by":"publisher","first-page":"811","DOI":"10.1007\/s00701-015-2696-x","article-title":"Hemodynamic alterations after stent implantation in 15 cases of intracranial aneurysm","volume":"158","author":"Wang","year":"2016","journal-title":"Acta Neurochir (Wien)."},{"key":"B23","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1016\/j.wneu.2017.07.157","article-title":"Flow Diversion and Outcomes of Vertebral Fusiform Aneurysms After Stent-Only Treatment: A Hemodynamic Study","volume":"107","author":"Li","year":"2017","journal-title":"World Neurosurg."},{"key":"B24","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1136\/neurintsurg-2020-017089","article-title":"Endovascular treatment of vertebral artery dissecting aneurysms: a 20-year institutional experience","volume":"14","author":"Catapano","year":"2022","journal-title":"J Neurointerv Surg."},{"key":"B25","doi-asserted-by":"publisher","first-page":"108","DOI":"10.3174\/ajnr.A4111","article-title":"International retrospective study of the pipeline embolization device: a multicenter aneurysm treatment study","volume":"36","author":"Kallmes","year":"2015","journal-title":"AJNR Am J Neuroradiol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1136\/neurintsurg-2014-011340","article-title":"reappraisal of the Pipeline embolization device for the treatment of posterior circulation aneurysms","volume":"7","author":"Albuquerque","year":"2015","journal-title":"J Neurointerv Surg."},{"key":"B27","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1227\/01.neu.0000431472.71913.07","article-title":"Endovascular treatment of complex aneurysms at the vertebrobasilar junction with flow-diverting stents: initial experience","volume":"73","author":"Meckel","year":"2013","journal-title":"Neurosurgery."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1116","DOI":"10.1016\/j.jocn.2013.11.010","article-title":"Delayed complications after flow-diverter stenting: reactive in-stent stenosis and creeping stents","volume":"21","author":"Cohen","year":"2014","journal-title":"J Clin Neurosci."},{"key":"B29","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1007\/s00062-015-0494-8","article-title":"Long-Term Outcome of Tubridge Flow Diverter(S) in Treating Large Vertebral Artery Dissecting Aneurysms-A Pilot Study","volume":"27","author":"Fang","year":"2017","journal-title":"Clin Neuroradiol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1007\/s00062-017-0591-y","article-title":"In-stent stenosis after p64 flow diverter treatment","volume":"28","author":"Aguilar P\u00e9rez","year":"2018","journal-title":"Clin Neuroradiol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"e1031","DOI":"10.1016\/j.wneu.2018.08.225","article-title":"Quantitative assessment of in-stent stenosis after pipeline embolization device treatment of intracranial aneurysms: a single-institution series and systematic review","volume":"120","author":"Ravindran","year":"2018","journal-title":"World Neurosurg."},{"key":"B32","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1227\/NEU.0000000000000409","article-title":"Increasing flow diversion for cerebral aneurysm treatment using a single flow diverter","volume":"75","author":"Xiang","year":"2014","journal-title":"Neurosurgery"},{"key":"B33","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1136\/neurintsurg-2019-015660","article-title":"Optical coherence tomography evaluation of vertebrobasilar artery stenosis: case series and literature review","volume":"12","author":"Xu","year":"2020","journal-title":"J Neurointerv Surg."},{"key":"B34","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1136\/neurintsurg-2016-012969","article-title":"Analysis of neointima development in flow diverters using optical coherence tomography imaging","volume":"10","author":"Matsuda","year":"2018","journal-title":"J Neurointerv Surg."}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2022.1012382\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,2]],"date-time":"2022-11-02T06:07:21Z","timestamp":1667369241000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2022.1012382\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,2]]},"references-count":34,"alternative-id":["10.3389\/fneur.2022.1012382"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2022.1012382","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,2]]},"article-number":"1012382"}}