To compare the impact of two flow diverter devices (Pipeline Embolization Device [PED] and Tubridge Embolization Device [TED]) on branch vessels patency in intracranial aneurysm treatment, with specific focus on branch vessel outcomes and clinical safety. A retrospective analysis of 320 patients with 430 aneurysms and 602 covered branches treated with PED or TED was conducted. Statistical analyses included descriptive statistics and group comparisons. Potential predictors of aneurysm and branch occlusion were identified through univariate analysis followed by multivariate logistic regression. Propensity score matching was adjusted for baseline discrepancies, and the comparative analysis examined stent efficacy on branch vessels patency and clinical outcomes. Stenosis or occlusion rates were 6.1% for the ophthalmic artery (OA), 31.6% for the posterior communicating artery (PComA), 0.9% for the anterior choroidal artery (AChA), 40.5% for the anterior cerebral artery (ACA), and 0% for the middle cerebral (MCA), lenticulostriate (LSA), posterior inferior cerebellar (PICA), and anterior inferior cerebellar arteries (AICA). Before propensity score matching, branch vessels patency rates did not significantly differ between the PED and TED groups. After matching, 109 pairs were identified. No significant differences in angiographic outcomes for distal and proximal branch vessels regarding occlusion or stenosis were observed between groups (P values >
0.999 and 0.332, respectively). Branch obliteration was mostly asymptomatic. PED and TED showed comparable safety profiles and branch vessel patency rates. These findings indicate that FD treatment may be clinically safe for selected ICA and VA cases requiring branch vessel coverage.