{
  "abstract": "Background The optimal selection of stent size remains uncertain. This study evaluated the impact of stent diameter on in-stent stenosis (ISS) after interventional therapy through a subgroup analysis of the Intracranial Aneurysms Managed by Parent Artery Reconstruction Using Tubridge Flow Diverter (IMPACT) trial.Methods This prospective, multicenter study included patients treated with the Tubridge Flow Diverter (TFD) at 14 centers between December 16, 2019 and October 26, 2022. The primary outcome was the incidence of ISS at the 12-month follow-up. We analyzed the effect of different stent sizes on ISS in all patients from IMPACT who had follow-up imaging. The parent artery was divided into proximal and distal vessels, and we introduced the ratio of diameter (RD) as a parameter to assess the association between stent diameter and vessel diameter.Results A total of 167 patients with 195 intracranial aneurysms were included. ISS was classified as mild (<25%) in 9 cases (5.4%), moderate (25–50%) in 4 cases (2.4%), severe (51–75%) in 1 case (0.6%), and extremely severe (>75%) in 5 cases (3%). A total of 390 proximal and distal vessels were evaluated, with a mean RD of 1.14±0.26. Smaller parent artery diameter and higher RD were significantly associated with ISS (p=0.002 and p=0.021, respectively). Additionally, the risk of ISS increased when RD>1.1 (p=0.006).Conclusions In TFD treatment for intracranial aneurysms, stent size and the diameters of proximal and distal parent arteries should be carefully considered, especially in cases involving small parent arteries. Maintaining an RD of less than 1.1 may reduce the risk of ISS.",
  "authors": [
    {
      "affiliations": [
        "Department of Cerebrovascular Disease, Henan University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, Henan, China"
      ],
      "name": "Jieyu Gao"
    },
    {
      "affiliations": [
        "Department of Cerebrovascular Disease, Henan University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, Henan, China",
        "Department of Cerebrovascular Disease, Zhengzhou University People's Hospital, Henan Provincial People’s Hospital, Zhengzhou, Henan, China"
      ],
      "name": "Qianqian Zhang"
    },
    {
      "affiliations": [
        "Neurosurgery, Changhai Hospital, Naval Medical University, Shanghai, Shanghai, China",
        "Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, Shanghai, China"
      ],
      "name": "Nan Lv"
    },
    {
      "affiliations": [
        "Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, Shanghai, China"
      ],
      "name": "Qiang Li"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Huashan Hospital Affiliated to Fudan University, Shanghai, Shanghai, China"
      ],
      "name": "Yuxiang Gu"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Huashan Hospital Affiliated to Fudan University, Shanghai, Shanghai, China"
      ],
      "name": "Liquan Xu"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China"
      ],
      "name": "Chuangren Huang"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China"
      ],
      "name": "Guohua Mao"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Jiangsu Province Hospital, Nanjing, Jiangsu, China"
      ],
      "name": "Hua Lu"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China"
      ],
      "name": "Shu Zhong"
    },
    {
      "affiliations": [
        "Department of Cerebrovascular Disease, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China"
      ],
      "name": "Chuanzhi Duan"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Xiaodong Xie"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Renji Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, Shanghai, China"
      ],
      "name": "Jieqing Wan"
    },
    {
      "affiliations": [
        "Department of Interventional Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Dalian, China"
      ],
      "name": "Feng Wang"
    },
    {
      "affiliations": [
        "Department of Neurointervention, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China"
      ],
      "name": "Sheng Guan"
    },
    {
      "affiliations": [
        "Department of Cerebrovascular Disease, Henan University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, Henan, China",
        "Department of Cerebrovascular Disease, Zhengzhou University People's Hospital, Henan Provincial People’s Hospital, Zhengzhou, Henan, China"
      ],
      "name": "Qiuji Shao"
    },
    {
      "affiliations": [
        "Department of Cerebrovascular Disease, Henan University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, Henan, China",
        "Department of Cerebrovascular Disease, Zhengzhou University People's Hospital, Henan Provincial People’s Hospital, Zhengzhou, Henan, China"
      ],
      "name": "Kaitao Chang"
    },
    {
      "affiliations": [
        "Department of Cerebrovascular Disease, Zhengzhou University People's Hospital, Henan Provincial People’s Hospital, Zhengzhou, Henan, China"
      ],
      "name": "Jinyi Ding"
    },
    {
      "affiliations": [
        "Department of Cerebrovascular Disease, Zhengzhou University People's Hospital, Henan Provincial People’s Hospital, Zhengzhou, Henan, China"
      ],
      "name": "Yingbo Lei"
    },
    {
      "affiliations": [
        "Department of Cerebrovascular Disease, Zhengzhou University People's Hospital, Henan Provincial People’s Hospital, Zhengzhou, Henan, China"
      ],
      "name": "Tianxiao Li"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing, Beijing, China"
      ],
      "name": "Ming Lv"
    },
    {
      "affiliations": [
        "Department of Cerebrovascular Disease, Henan University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, Henan, China",
        "Department of Cerebrovascular Disease, Zhengzhou University People's Hospital, Henan Provincial People’s Hospital, Zhengzhou, Henan, China"
      ],
      "name": "Li Li"
    },
    {
      "affiliations": [
        "Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, Shanghai, China"
      ],
      "name": "Jianmin Liu"
    }
  ],
  "title": "Threshold ratio of stent-to-vessel diameter related to in-stent stenosis after flow diverter treatment of intracranial aneurysm",
  "uid": "4b3590c2-29e9-59f8-8002-199c85666193"
}