Endovascular treatment of challenging aneurysms with FRED Jr flow diverter stents: a single-center experience

Sayın, Bige; Şenol, Yiğit Can; Dağlıoğlu, Ergün; Özbakır, Musa Onur; Orhan, Gürdal; Akmangit, İlkay

doi:10.1007/s11604-022-01354-2

Cited by 5 publications

(4 citation statements)

References 38 publications

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“…For aneurysm occlusion, good OKM grades (grade C and D) indicate good occlusion and treatment effect. For the FRED flow diverter, the complete aneurysm occlusion (grade D) rate has been reported to range from 66 to 87% or even 100%, with the complete occlusion rate being continuously increased with extension of the follow-up time 27 – 29 . In reporting angiographic follow-up outcomes of 71 patients with 77 large or giant cerebral aneurysms treated with the Pipeline flow diverter (excluding 7 patients with parent artery occlusion) 30 , complete aneurysm occlusion (OKM grade D) was achieved in 64.9% aneurysms 6 months after embolization, 76.6% after 1 year, and 77.9% at 3-years follow-up, with the trend of occlusion being gradually increased over time.…”

Section: Discussionmentioning

confidence: 99%

Use of the Tubridge flow diverter in the treatment of intracranial aneurysms: a single center experience

Li,

Gao,

et al. 2024

Sci Rep

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To investigate the safety and effect of Tubridge flow diverter deployment for the treatment of intracranial aneurysms, 85 patients with intracranial aneurysms treated with the Tubridge flow diverter were retrospectively enrolled. The clinical data including the baseline data, aneurysm parameters before and after treatment, and follow-up outcomes were assessed. Among 85 patients, there were 35 (41.2%) males and 50 females (58.8%) aged 17–77 (mean 56.7 ± 11.1) years with 110 aneurysms. Five (5.9%) patients initially presented with subarachnoid hemorrhage from aneurysm rupture. The aneurysm size was 2–30 (mean 8.6) mm, and the aneurysm neck was 2–10.6 (mean 5.7 ± 2.3) mm. Ninety-three Tubridge stents were deployed. Twenty-five (29.4%) patients experienced adjunctive loose coiling. Blood flow was significantly reduced from entering the aneurysm after stent deployment. Periprocedural complications occurred in three (3.5%) patients, including in-stent thrombosis during embolization in one patient (1.2%), conjunctiva edema on the right in one patient (1.2%), and acute multiple cerebral infarctions in one patient (1.2%). Angiographic follow-up was conducted in 67 (78.8%) patients 3–36 (mean 15.3 ± 5.6) months later. In 11 (16.4% or 11/67) patients, blood flow still entered the aneurysm with the O’Kelly-Marotta (OKM) grade B in two (3.0%) patients and grade C in nine (13.4%), whereas complete occlusion (OKM grade D) was achieved in the other 56 (83.6% or 56/67) aneurysms. In-stent stenosis was present in five (7.5%) patients with approximately 25% stenosis in three (4.5%) patients and 50% in two (3.0%). In conclusion, the Tubridge flow diverter can be safely and efficiently applied in the treatment of small and large intracranial aneurysms, with a low periprocedural complication rate, a high occlusion degree, and a low in-stent stenosis rate at follow-up even though large aneurysms may necessitate a longer surgical time and adjunctive coiling.

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Section: Discussionmentioning

confidence: 99%

Use of the Tubridge flow diverter in the treatment of intracranial aneurysms: a single center experience

Li,

Gao,

et al. 2024

Sci Rep

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“…The results in our present series are corroborated by previously published literature. Sayin et al 11 reported 5 cases with acute SAH treated with the FRED Jr stent, which included 2 distal ACA aneurysms, 2 posterior communicating artery wide-necked aneurysms, and 1 fusiform PCA aneurysm. In all of the patients in this series, no residual filling of the neck or part of the aneurysm was observed at follow-up, and no rebleeding events were reported.…”

Section: Discussionmentioning

confidence: 99%

“…10 To date, there are only limited data regarding the use of the FRED Jr stent in the setting of subarachnoid hemorrhage (SAH). 11,12 In this study, we report our experience with ruptured cerebral aneurysms arising from small-caliber arteries treated in the acute period by use of the FRED Jr stent.…”

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confidence: 99%

FRED Jr stent for acute flow diversion in ruptured cerebral aneurysms arising from small-caliber vessels: a clinical case series

Doron

McLellan

Vranic

et al. 2023

Neurosurgical Focus

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OBJECTIVE Treatment of ruptured aneurysms arising from small-caliber (< 2.5 mm) or distal vessels beyond the circle of Willis is considered challenging with all treatment modalities. Recently, the Flow Re-Direction Endoluminal Device Junior (FRED Jr) stent, designed for flow diversion in small arteries, was approved in the United States for the treatment of nonruptured aneurysms. Here, the authors report their experience using this device in the setting of subarachnoid hemorrhage (SAH). METHODS Clinical and radiological records of patients sustaining SAH treated with a FRED Jr stent between June 2020 and October 2022 were reviewed. Treatment course, including antiplatelet therapy, external ventricular drain (EVD) management, and vasospasm, and clinical outcomes were analyzed. Angiographic results were assessed according to the O’Kelly-Marotta (OKM) grading scale. RESULTS Nine patients at a median age of 62 (range 27–75) years were included. The median Hunt and Hess grade was II (IQR I) and the median modified Fisher grade was 4 (IQR 1). Aneurysm morphology types included saccular (6 patients), blister (1 patient), and dissecting (2 patients), and the aneurysms were located at the anterior communicating artery complex (n = 3) at the A2/A3 (n = 3), M2/M3 (n = 1), V4 (n = 1), and P2 (n = 1) arterial segments. All stents were deployed successfully with no intraprocedural complications. Postoperatively, no rebleeding events were encountered. Vasospasm therapy was initiated in 6 patients, and no symptomatic EVD-related hematomas were observed. Postoperative ischemic events were encountered in 2 patients. The median 3-month modified Rankin Scale score was 2 (IQR 1) for the 7 surviving patients, and 3-month radiographic follow-up revealed OKM grade D in 4 of 7 patients. CONCLUSIONS Flow diversion using the FRED Jr stent is feasible as a potential treatment strategy for acutely ruptured aneurysms arising from small-caliber vessels. The complication profile reported in this series is comparable to those of historical microsurgical cohorts, and effective protection was conferred by this treatment modality. Therefore, our small cohort provides a glimpse into a new tool for successfully achieving acute flow diversion for this subset of difficult-to-treat aneurysms.

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“…Neurosurgery is one of the most developing departments thanks to recent technological improvements (4). Today, neurosurgeons perform endoscopic, endovascular, radiosurgery and stereotactic minimally invasive procedures besides microsurgery (5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Türkiye'deki Öğrencilerin Nöroşirürji ve Diğer Uzmanlık Kariyer Tercihlerinin Karşılaştırılması

EREN,

KARAGÖZ GUZEY,

GÜLEÇ

et al. 2023

Tıp Eğitimi Dünyası

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Objective: The reasons why neurosurgery residency is preferred by students who have low success rates in exams and how to change this were researched in Türkiye. Material and Methods: Between 2014-2021, the lowest and highest Medical Specialty Exam (TUS) scores of students who started neurosurgery residency in 14 exam periods in Türkiye were determined. The scores of the other 39 specialties in the same exams were also determined and they were compared with neurosurgery scores. Moreover in the 2022-2023 academic year, a survey conducted with the students of 12 medical faculties in all geographical regions in Türkiye. 3590 students participated in the study. Participants answered 11 questions about career choices and neurosurgery. Results: The mean neurosurgery TUS score was 53.3±1.31. It was seen that 21.8% of the 1023 neurosurgery quotas were not preferred. The ranking of neurosurgery scores of TUS was between 29th and 36th among 40 specialties. The average scores of neurosurgery in metropolitan cities faculties were significantly higher than in other university hospitals and institutional hospitals (p = 0,008, p = 0,002; respectively). Students were less interested in surgical specialties in their senior year (p=0.004). While those considering a career in neurosurgery were 22.3% in the first two years, this rate decreased to 6.3% in the last two years (p

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Endovascular treatment of challenging aneurysms with FRED Jr flow diverter stents: a single-center experience

Cited by 5 publications

References 38 publications

Use of the Tubridge flow diverter in the treatment of intracranial aneurysms: a single center experience

Use of the Tubridge flow diverter in the treatment of intracranial aneurysms: a single center experience

FRED Jr stent for acute flow diversion in ruptured cerebral aneurysms arising from small-caliber vessels: a clinical case series

Türkiye'deki Öğrencilerin Nöroşirürji ve Diğer Uzmanlık Kariyer Tercihlerinin Karşılaştırılması

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