Safety and efficacy of flow re-direction endoluminal device (FRED) in the treatment of cerebral aneurysms: a single center experience

Briganti, Francesco; Leone, Giuseppe; Ugga, Lorenzo; Marseglia, Mariano; Solari, Domenico; Caranci, Ferdinando; Mariniello, Giuseppe; Maiuri, Francesco; Cappabianca, Paolo

doi:10.1007/s00701-016-2875-4

Cited by 35 publications

(18 citation statements)

References 32 publications

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“…Similarly, Möhlenbruch et al 14 showed progressive aneurysmal occlusion with 73% of aneurysms completely occluded at the 6 months' follow-up while Briganti et al 15 had occlusion rates of 83%. The safety profile also seems comparable to the other devices with no deaths seen in the studies and morbidity seen in 10% of cases in the series by Möhlenbruch and 8% in that of Briganti et al 15 The p64 is a braided FDS composed of 64 nitinol wires. Two platinum wires wrapped around the shaft assist in radio-opacity.…”

Section: Introductionsupporting

confidence: 53%

Use of flow diverters in the treatment of unruptured saccular aneurysms of the anterior cerebral artery

Bhogal

Moreno

Ganslandt

et al. 2016

J NeuroIntervent Surg

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BackgroundFew publications have dealt exclusively with the use of flow diverter stents for the treatment of aneurysms of the anterior cerebral artery (ACA).ObjectiveTo determine the efficacy of flow-diverting stents in the treatment of small, unruptured aneurysms of the ACA.MethodsWe retrospectively reviewed our database of prospectively collected information for all patients treated with flow diversion for an unruptured saccular aneurysm of the ACA between September 2009 and July 2016. The aneurysm fundus size, neck size, number and type of flow-diverting stent (FDS), complications, and follow-up data were recorded.ResultsIn total 26 patients, with 27 aneurysms were identified that matched our inclusion criteria (11 male and 15 female). The average age of the patients was 59.3 years (range 27–77 years). All patients, except one, had a single aneurysm affecting the ACA. Fourteen aneurysms were located on the left (51.9%). The average aneurysm fundus size was 2.9 mm (range 2–6 mm). Twenty patients had follow-up angiographic studies. In total, 16 aneurysms were completely excluded, 1 aneurysm showed a very small remnant, and no follow-up angiographic data are available for the remaining patients. One patient had a treatment-related complication.ConclusionsTreatment of aneurysms arising from the ACA with flow diverters is technically feasible and carries a high degree of success with low complication rate.

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Section: Introductionsupporting

confidence: 53%

Use of flow diverters in the treatment of unruptured saccular aneurysms of the anterior cerebral artery

Bhogal

Moreno

Ganslandt

et al. 2016

J NeuroIntervent Surg

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“…1,2,[4][5][6][7][8]10,11,13 In addition, recent cost-effectiveness analyses have favored flow diversion over alternative endovascular treatments, particularly for large or giant aneurysms. 11 However, consensus has not been reached as regards the long-term stability of treatment and complication rates.…”

Section: Discussionmentioning

confidence: 99%

Postprocedural, midterm, and long-term results of cerebral aneurysms treated with flow-diverter devices: 7-year experience at a single center

Briganti¹,

Leone²,

Cirillo

et al. 2017

Neurosurgical Focus

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OBJECTIVEFlow diversion has emerged as a viable treatment option for selected intracranial aneurysms and recently has been gaining traction. The aim of this study was to evaluate the safety and effectiveness of flow-diverter devices (FDDs) over a long-term follow-up period.METHODSThe authors retrospectively reviewed all cerebral aneurysm cases that had been admitted to the Division of Neurosurgery of the Università degli Studi di Napoli between November 2008 and November 2015 and treated with an FDD. The records of 60 patients (48 females and 12 males) harboring 69 cerebral aneurysms were analyzed. The study end points were angiographic evidence of complete aneurysm occlusion, recanalization rate, occlusion of the parent artery, and clinical and radiological evidence of brain ischemia. The occlusion rate was evaluated according to the O’Kelly-Marotta (OKM) Scale for flow diversion, based on the degree of filling (A, total filling; B, subtotal filling; C, entry remnant; D, no filling). Postprocedural, midterm, and long-term results were strictly analyzed.RESULTSComplete occlusion (OKM D) was achieved in 63 (91%) of 69 aneurysms, partial occlusion (OKM C) in 4 (6%), occlusion of the parent artery in 2 (3%). Intraprocedural technical complications occurred in 3 patients (5%). Postprocedural complications occurred in 6 patients (10%), without neurological deficits. At the 12-month follow-up, 3 patients (5%) experienced asymptomatic cerebral infarction. No further complications were observed at later follow-up evaluations (> 24 months). There were no reports of any delayed aneurysm rupture, subarachnoid or intraparenchymal hemorrhage, ischemic complications, or procedure- or device-related deaths.CONCLUSIONSEndovascular treatment with an FDD is a safe treatment for unruptured cerebral aneurysms, resulting in a high rate of occlusion. In the present study, the authors observed effective and stable aneurysm occlusion, even at the long-term follow-up. Data in this study also suggest that ischemic complications can occur at a later stage, particularly at 12–18 months. On the other hand, no other ischemic or hemorrhagic complications occurred beyond 24 months.

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“…2,3 Due to its singular design, a metal-covered inner stent layer with low permeability and an outer, more porous and stable stent scaffold, the Flow Re-Direction Endoluminal Device (FRED; MicroVention, Tustin, California) may be superior to other flow diverters, providing safer delivery and more effective occlusion of the aneurysm. [4][5][6][7][8][9] The FRED Jr (MicroVention) has a similar dual-layer design and is the first flow diverter dedicated to small vessels (ie, Յ3 mm). In the past, the flow diverter was not widely used in the treatment of distal circulation aneurysms due to their relatively superficial anatomy and good accessibility for microsurgical clipping.…”

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confidence: 99%

Multicenter Experience with FRED Jr Flow Re-Direction Endoluminal Device for Intracranial Aneurysms in Small Arteries

Möhlenbruch

Kızılkılıç

Killer‐Oberpfalzer

et al. 2017

AJNR Am J Neuroradiol

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Safety and efficacy of flow re-direction endoluminal device (FRED) in the treatment of cerebral aneurysms: a single center experience

Abstract: Endovascular treatment with FRED FDD is a safe treatment for unruptured cerebral aneurysms, resulting in a high rate of occlusion. The FRED is substantially equivalent to the other known FDDs, which show similar functions and technical profiles.

Cited by 35 publications

References 32 publications

Use of flow diverters in the treatment of unruptured saccular aneurysms of the anterior cerebral artery

Use of flow diverters in the treatment of unruptured saccular aneurysms of the anterior cerebral artery

Postprocedural, midterm, and long-term results of cerebral aneurysms treated with flow-diverter devices: 7-year experience at a single center

Multicenter Experience with FRED Jr Flow Re-Direction Endoluminal Device for Intracranial Aneurysms in Small Arteries

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