Efficacy and safety of Pipeline Embolization Device versus Tubridge flow diverter for unruptured intracranial aneurysms: a systematic review and meta-analysis

Arruda G.; Ribeiro Gonçalves O.; Machado Magalhães P.L.; Fernandes J.V.A.; Camarotti M.T.; Ribeiro F.V.; de Bastos Maximiano M.L.; Bocanegra-Becerra J.E.; Günkan A.; Ferreira M.Y.; Ferreira C.; Gordon D.; Serulle Y. · Neurological Research (2026) · DOI: 10.1080/01616412.2026.2620488

Resumen

Objective: To compare the outcomes of flow diversion treatment with Pipeline Embolization Device (PED) and Tubridge Flow Diverter (TFD) in unruptured intracranial aneurysms. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines. The primary outcome was complete aneurysm occlusion. Secondary outcomes included favorable functional outcomes (modified Rankin Scale 0–2), perioperative ischemic and hemorrhagic complications, and in-stent stenosis. Risk ratios (RR) with 95% confidence intervals (CI) were pooled using the Mantel-Haenszel method under a random-effects model. Heterogeneity was assessed using the I2 statistic. Statistical analyses were performed using R software (version 4.4.0). Results: Four studies including 913 patients were analyzed; 462 underwent treatment with TFD and 451 with PED. Complete aneurysm occlusion was achieved in 75.96% of TFD cases and 81.64% of PED cases (RR: 0.93; 95% CI: 0.87–1.00; I2 = 0%). Favorable functional outcomes occurred in 97.07% (TFD) and 96.84% (PED) (RR: 1.00; 95% CI: 0.98–1.02; I2 = 0%). Ischemic complications were slightly higher in TFD (4.11%) than in PED (2.44%) (RR: 1.67; 95% CI: 0.39–7.10; I2 = 53.7%). Hemorrhagic complications were low in both groups (0.26% vs. 0.54%; RR: 0.55; 95% CI: 0.07–4.39; I2 = 0%). In-stent stenosis occurred in 15.06% (TFD) and 16.08% (PED) (RR: 0.94; 95% CI: 0.66–1.33; I2 = 0%). Conclusion: PED and TFD demonstrate comparable efficacy and safety profiles for the treatment of unruptured intracranial aneurysms. Both devices are effective options for endovascular therapy.

Instituciones: Universidad Peruana Cayetano Heredia