Comparison of flow diverter devices and endovascular coiling to treat intracranial aneurysms with an incorporated branch: A retrospective cohort study

ObjectiveThis study aimed to compare the clinical and angiographic outcomes of aneurysms with an incorporated branch treated using traditional endovascular coiling or a flow diverter device.MethodsThis single-center retrospective cohort study was conducted at Yixing People's Hospital from January 2015 to December 2023. The final analysis included 63 aneurysms treated with a pipeline embolization device (with or without coils) and 69 treated with endovascular coiling (with or without traditional stents).ResultsOverall, 26 aneurysms (41.3%) in the pipeline embolization device group and 44 (63.8%) in the coiling group achieved complete or near complete occlusion (<i>p</i> = 0.009). At follow-up, 16 branches (25.4%) in the pipeline embolization device group and 12 (17.4%) in the coiling group were occluded (<i>p</i> = 0.523). The stent-assisted coiling subgroup showed a significantly higher aneurysm occlusion rate than the pipeline embolization device group (<i>p</i> = 0.004), whereas no significant difference in branch occlusion rate was observed between the two groups (<i>p</i> = 0.285).ConclusionsFor aneurysms with incorporated branches, stent-assisted coil embolization achieves a higher aneurysm occlusion rate than with pipeline embolization device treatment, without a corresponding increase in branch artery occlusion. If the incorporated branch is considered sacrifiable (its loss would not result in significant neurological deficits), stent-assisted coiling should be regarded as the preferred treatment option.