Artikel
Treatment of intracranial aneurysms using the Flow Re-Direction Endoluminal Device (FRED): multi-center experience and follow-up results
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Veröffentlicht: | 8. Juni 2016 |
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Gliederung
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Objective: Flow diversion emerged to a crucial treatment option for intracranial aneurysms. We report our retrospective analysis of the safety and efficacy in the treatment of intracranial aneurysms with the FRED flow diverter, a double layer flow modulation device.
Method: All intracranial aneurysms treated with the FRED between 03/2013 and 05/2015 in three neurovascular centers were included. Angiographic and clinical results were retrospectively analyzed including the follow-up periods. Aneurysms were unruptured in 40 cases whereas six treatments were due to an acute SAH from the target aneurysm.
Results: Successful implantation of the FRED was possible in 45/47 (95,74%) cases. Incomplete opening of the device or detachment problems occurred in 4 cases with a modification of the treatment concept in two cases (failed attempt). Additional coiling was performed in six cases. At three month follow-up, complete occlusion (OKM D) was reached in 24/39 (59%) cases and near-complete occlusion (OKM C) was reached in 9/39 cases (23%). At nine month follow-up, aneurysm occlusion was complete in 14/21 (67%) or near-complete in 6/21 cases (29%). Clinically relevant complications related the procedure occurred in 8/45 (17,78%) cases. The overall permanent morbidity and mortality in our series is 2/45 (4,44%) and 2/45 (4,44%) to date.
Conclusions: The FRED device offers an effective tool in the treatment of intracranial aneurysms by flow diversion with contemporary aneurysm occlusion probably accelerated by the double layer design. Further studies might therefor help to identify an idealized antiplatelet regime. However, these results need to be confirmed with mid- and long-term follow-up results of multicenter large series.