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67th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Korean Neurosurgical Society (KNS)

German Society of Neurosurgery (DGNC)

12 - 15 June 2016, Frankfurt am Main

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Treatment of intracranial aneurysms using the Flow Re-Direction Endoluminal Device (FRED): multi-center experience and follow-up results

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  • Finn Drescher - Institut für Diagnostische und Interventionelle Radiologie, Neuroradiologie und Nuklearmedizin, Universitätsklinikum Knappschaftskrankenhaus Bochum, Germany
  • Ansgar Berlis - Klinik für Diagnostische Radiologie und Neuroradiologie, Klinikum Augsburg, Germany
  • Stefan Rohde - Klinik für Radiologie und Neuroradiologie, Klinikum Dortmund, Germany
  • Werner Weber - Institut für Diagnostische und Interventionelle Radiologie, Neuroradiologie und Nuklearmedizin, Universitätsklinikum Knappschaftskrankenhaus Bochum, Germany
  • Sebastian Fischer - Institut für Diagnostische und Interventionelle Radiologie, Neuroradiologie und Nuklearmedizin, Universitätsklinikum Knappschaftskrankenhaus Bochum, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocDI.16.07

doi: 10.3205/16dgnc194, urn:nbn:de:0183-16dgnc1947

Published: June 8, 2016

© 2016 Drescher et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

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.