From the Department of Interventional Neuroradiology (L.B.M., P.M.M.F., G.M., J.R.V.), Neurology and Neurosurgery Service, Clinicas Hospital of Passo Fundo, Passo Fundo, Rio Grande do Sul, Brazil
Department of Interventional Neuroradiology (R.B.S., A.M.B.), Beneficente Portuguesa Hospital, Belém, Brazil
AJNR Am J Neuroradiol. 2021 Oct;42(10):1822-1826. doi: 10.3174/ajnr.A7258. Epub 2021 Aug 19.
The development of flow diverters has changed the endovascular approach to intracranial aneurysms. On the basis of good results, the indications for flow diverters have expanded to include aneurysms of different shapes, locations, and sizes. The objective of the study was to report on the performance of the Flow Re-Direction Endoluminal Device (FRED) in intracranial aneurysm treatment at early and medium-term follow-up.
This single-arm, multicentric, prospective, observational study assessed aneurysm treatment with the FRED. The primary outcome was complete aneurysm occlusion at 6 and 12 months, and the secondary outcome was to evaluate the safety of the FRED with respect to stroke and death rates.
Between June 2016 and August 2018, a total of 100 consecutive patients with 131 aneurysms were treated in 107 procedures. Total occlusion rates were 91% and 95% at 6 and 12 months. There was 1 death, and the total final morbidity rate was 1.8%. The complication rate was 4.6%.
As reported previously, the FRED has proved to be a safe and effective tool, with high occlusion rates. The design of the stent makes it more difficult to perform balloon angioplasty compared with similar devices. A branch arising from the aneurysm sac was found to be a predictor of nonocclusion at 12 months, though larger series are needed to estimate the magnitude of the association.
血流导向装置的发展改变了颅内动脉瘤的血管内治疗方法。基于良好的结果,血流导向装置的适应证已经扩展到包括不同形状、位置和大小的动脉瘤。本研究的目的是报告 Flow Re-Direction Endoluminal Device(FRED)在颅内动脉瘤治疗中的早期和中期随访结果。
这是一项单臂、多中心、前瞻性、观察性研究,评估了 FRED 在颅内动脉瘤治疗中的应用。主要结局是 6 个月和 12 个月时的完全动脉瘤闭塞,次要结局是评估 FRED 的安全性,包括卒中和死亡率。
2016 年 6 月至 2018 年 8 月,共 100 例连续患者的 131 个动脉瘤在 107 例手术中接受了治疗。6 个月和 12 个月时的完全闭塞率分别为 91%和 95%。有 1 例死亡,总最终发病率为 1.8%。并发症发生率为 4.6%。
如前所述,FRED 已被证明是一种安全有效的工具,具有较高的闭塞率。与类似装置相比,支架的设计使得进行球囊血管成形术更加困难。在 12 个月时,发现动脉瘤囊内分支是未闭塞的预测因素,尽管需要更大的系列来估计关联的程度。