Flow Re-direction Endoluminal Device in treatment of cerebral aneurysms: initial experience with short-term follow-up results

Clinical article

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  • 1 Division of Neuroradiology, Department of Radiology, and
  • 3 Department of Anesthesiology and Reanimation, Cerrahpasa Medical Faculty, Istanbul University; and
  • 2 Department of Radiology, GATA Haydarpasa Teaching Hospital, Istanbul, Turkey
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Object

Flow diverter (FD) stents are relatively new and important devices in the treatment of cerebral aneurysms. The Flow Re-Direction Endoluminal Device has been recently released for clinical use. The authors' aim in this paper is to report their initial single-center FRED experience with short-term results.

Methods

Between February 2012 and May 2013, 33 patients with 37 aneurysms (35 unruptured and 2 previously ruptured aneurysms) were treated with the FRED. Clinical and radiological data of the patients were retrospectively reviewed.

Results

In all patients only 1 device was used without any additional device or material, such as a stent or coil. All procedures were successfully performed. The procedural complication rate was 3% (1 of 33). Thirty patients underwent clinical and radiological follow-up. During the follow-up period, changes in stent morphology, such as “fish mouth” and “foreshortening” phenomena, occurred in 5 patients. The mortality and permanent morbidity rates were 0%. The complete occlusion rates were 32% (6 of 19) at 0–1 month, 67% (8 of 12) at 2–3 months, 80% (4 of 5) at 4–6 months, and 100% (8 of 8) at 7–12 months. The rates for some aneurysms were assessed at more than one time point.

Conclusions

The FRED has an ability to serve neurointerventionalists in the treatment of cerebral aneurysms with its different technical advantages. The occlusion rates with FRED are similar to those with other FD devices. However, these short-term results need to be confirmed with mid- and long-term follow-up results of multicenter large series.

Abbreviations used in this paper:ACA = anterior cerebral artery; DS = digital subtraction; DSA = DS angiography; FRED = Flow Re-Direction Endoluminal Device; FD = flow diverter; FDCT = flat-detector CT; FDCTA = flat-detector CT angiography; ICA = internal carotid artery; mRS = modified Rankin Scale; PED = Pipeline Embolization Device; TIA = transient ischemic attack; VA = vertebral artery.

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Contributor Notes

Address correspondence to: Naci Kocer, M.D., Department of Radiology, Division of Neuroradiology, Cerrahpasa Medical Faculty, Istanbul University, Kocamustafapasa/Istanbul 34098, Turkey. email: nkocer@istanbul.edu.tr.

Please include this information when citing this paper: published online March 14, 2014; DOI: 10.3171/2014.1.JNS131442.

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