Treatment of Intra- and Extracranial Aneurysms Using the Flow-Redirection Endoluminal Device: Multicenter Experience and Follow-Up Results.
Flow diversion emerged as a crucial treatment option for intracranial aneurysms. We report a multicenter retrospective analysis of the safety and efficacy in the treatment of intracranial aneurysms with the Flow-Redirection Endoluminal Device (FRED) flow diverter, a dual-layer flow-modulation device.



All intracranial aneurysms treated with the FRED between March 2013 and February 2016 at 4 neurovascular centers were included. Angiographic and clinical results were retrospectively analyzed, including all follow-up examinations. Aneurysms were unruptured in 44 cases, whereas 8 treatments were due to an acute SAH from the target aneurysm.



Successful implantation of the FRED was possible in 96.2% (50/52) of cases. At 3-month follow-up, complete occlusion was determined in 58.1% (25/43) and near-complete in 25.6% (11/43). At 12-month follow-up, aneurysm occlusion was complete in 75.0% (27/36) and near-complete in 22.2% (8/36). The overall acute and late thromboembolic and hemorrhagic complication rate was 17.3% (9/52), with a permanent treatment-related morbidity and mortality of 4.0% (2/50) and 2.0% (1/50), respectively, to date.



The FRED device offers an effective tool in the treatment of intracranial aneurysms. The dual-layer design promotes contemporary and stable long-term occlusion rates. Sufficient device expansion should be documented by angiographic CT. Further studies might help to identify a more optimal antiplatelet regimen to avoid thromboembolic complications during the follow-up period.
From the Knappschaftskrankenhaus Bochum (F.D., W.W., S.F.), Universitätsklinik, Institut für Diagnostische und Interventionelle Radiologie, Neuroradiologie, Nuklearmedizin, Bochum, Germany.
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0000-0002-9078-1466
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Drescher
From the Knappschaftskrankenhaus Bochum (F.D., W.W., S.F.), Universitätsklinik, Institut für Diagnostische und Interventionelle Radiologie, Neuroradiologie, Nuklearmedizin, Bochum, Germany.|Knappschaftskrankenhaus Recklinghausen Klinik für Radiologie Neuroradiologie und Nuklearmedizin (W.W.), Recklinghausen, Germany.
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0000-0001-9825-8074
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Weber
Klinikum Augsburg (A.B.), Klinik für Diagnostiche Radiologie und Neuroradiologie, Augsburg, Germany.
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0000-0001-5321-5118
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Berlis
Klinikum Dortmund (S.R.), Klinik für Radiologie und Neuroradiologie, Dortmund, Germany.
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0000-0002-6184-8617
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Rohde
Knappschaftskrankenhaus Bochum (A.C.), Universitätsklinik, Klinik für Neurochirurgie, Bochum, Germany.
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0000-0002-9753-4265
A
Carolus
From the Knappschaftskrankenhaus Bochum (F.D., W.W., S.F.), Universitätsklinik, Institut für Diagnostische und Interventionelle Radiologie, Neuroradiologie, Nuklearmedizin, Bochum, Germany sebif101@googlemail.com.
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0000-0003-3267-917X
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Fischer
D000328:Adult; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome