Fulda Clinic, Clinic for Neurosurgery, Fulda, Germany.
Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, India.
Expert Rev Med Devices. 2021 Feb;18(2):139-144. doi: 10.1080/17434440.2021.1879636. Epub 2021 Jan 27.
The treatment of intracranial aneurysms has significantly evolved over the last decade with the advancement in endovascular techniques and devices. Flow diverters are the latest in the armamentarium for vascular reconstruction, aneurysm exclusion, and preservation of branch vessels. The possibility of treating various types of intracranial aneurysms, including those previously considered untreatable, has represented a new paradigm in the neurovascular era.
This paper describes in detail the current status in the use of new generation double-layered Flow Redirection Endoluminal Device (FRED; MicroVention Terumo, Tustin, California). For this report, we reviewed the published literature for properties of the currently available FRED devices regarding safety, efficacy, and potential risks and complications associated with their use.
FRED and FRED Jr are the new flow diverter devices for which the existing data suggest that they are safe and efficient in addressing the treatment issues with giant, wide-necked saccular and fusiform aneurysms and those with perforators and branch vessels at high risk of occlusion with surgical clipping. Evidence is mounting on their long-term durability which increases the confidence of both the endovascular surgeon in prescribing and the patient side in accepting these FDs as treatment option for intracranial aneurysms.
在过去十年中,随着血管内技术和设备的进步,颅内动脉瘤的治疗有了显著的发展。血流导向装置是血管重建、动脉瘤排除和分支血管保护的最新武器。治疗各种类型颅内动脉瘤的可能性,包括以前认为无法治疗的动脉瘤,代表了神经血管时代的一个新范例。
本文详细描述了新一代双层血流转向腔内装置(FRED;Microvention Terumo,加利福尼亚州图森)的当前使用情况。为此报告,我们回顾了已发表的文献,以了解目前可用的 FRED 装置在安全性、疗效以及与使用相关的潜在风险和并发症方面的特性。
FRED 和 FRED Jr 是新型血流导向装置,现有数据表明,它们在治疗大型、宽颈囊状和梭形动脉瘤以及那些具有高闭塞风险的穿支血管和分支血管方面是安全有效的,这些动脉瘤可以通过手术夹闭来治疗。它们的长期耐用性的证据越来越多,这增加了血管内外科医生开具处方的信心和患者接受这些 FD 作为颅内动脉瘤治疗选择的信心。