Predictive factors of delayed braid deformation in DFT flow diverters

Area of Science:

• Neurosurgery
• Interventional Radiology
• Medical Devices

Background:

• Flow diverter braid deformation (FDBD) is a concern with platinum drawn-filled tube (DFT) wire devices.
• Predictive factors for FDBD remain unclear, necessitating clinical analysis.

Purpose of the Study:

• To determine the incidence, patterns, and predictors of FDBD in patients treated with DFT wire flow diverters.
• To identify patient and procedural factors associated with FDBD.

Main Methods:

• Retrospective analysis of intracranial aneurysms treated with DFT wire flow diverters (June 2018-June 2024).
• High-resolution cone-beam CT (vasoCT) and angiograms used to identify and classify FDBD.
• Univariate and multivariable analyses of patient, aneurysm, anatomy, procedural, and device characteristics.

Main Results:

• FDBD was observed in 27% of 102 patients (41 deformations).
• Independent predictors of FDBD included short distal landing zone, proximal flow diverter oversizing, and younger patient age.
• Internal carotid artery aneurysms showed association with FDBD in univariate analysis.

Conclusions:

• FDBD is a frequent complication (approx. 25%) of DFT flow diverters, linked to symptomatic issues but not permanent morbidity.
• Patient age and technical factors (landing zone, oversizing) are significant predictors of FDBD.
• Findings can guide clinical decisions and future research for DFT flow diverter use.