Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Clin Neurol Neurosurg. 2022 Dec;223:107483. doi: 10.1016/j.clineuro.2022.107483. Epub 2022 Oct 25.
With the development of the Flow Re-Direction Endoluminal Device Junior (FRED Jr), treatment of distal aneurysms and/or aneurysms with small parent vessels has become a viable option.
To assess the efficacy and safety of FRED Jr in the treatment of distal aneurysms with small parent vessels.
This is a single center retrospective study and meta-analysis of patients treated with FRED Jr for intracranial aneurysms. The primary outcome was complete aneurysm occlusion at final follow-up. Secondary outcomes included stroke rates, mortality rates, need for retreatment and clinical outcomes.
There were a total of 7 patients with 7 aneurysms treated with FRED Jr. Mean aneurysm neck, width, height, and parent artery diameter were 2.6 ± 0.8 mm, 3.1 ± 0.9 mm, 2.5 ± 1.0 mm, and 1.8 ± 0.6 mm respectively. The complete occlusion rate was 57.1 % at 6 months, and favorable outcome (mRS 0-2) was observed in all patients in follow-up. Stroke complication occurred in none of the patients. Seven studies from 1360 articles were identified for inclusion in the meta-analysis, comprising 227 patients with 244 aneurysms treated with FRED Jr. Mean aneurysm height, width, neck and parent artery diameter were 6.9 ± 3.3 mm (pooled=5.6 [<0.1-11.47] mm), 6.6 ± 2.2 mm (pooled=6.6 [4.2-9.1] mm), 4.4 ± 1.4 mm (pooled=4.1 [3.3 -4.9] mm), and 2.0 ± 0.2 mm (pooled=2.1 [1.7-2.5]), respectively. At final follow-up, the pooled complete occlusion and complication rates were 69.9 % and 0 %, respectively.
FRED Jr demonstrated moderate efficacy and good safety in the treatment of distal aneurysms with small parent vessels at mid-term follow-up.
随着血流导向装置 Junior（FRED Jr）的发展，治疗远端动脉瘤和/或小血管母瘤已成为一种可行的选择。
评估 FRED Jr 治疗小血管母瘤的远端动脉瘤的疗效和安全性。
这是一项单中心回顾性研究和 FRED Jr 治疗颅内动脉瘤的荟萃分析。主要结局是最终随访时完全闭塞动脉瘤。次要结局包括卒中和死亡率、需要再次治疗和临床结果。
共有 7 例患者的 7 个动脉瘤接受了 FRED Jr 治疗。平均动脉瘤颈、宽度、高度和母动脉直径分别为 2.6±0.8mm、3.1±0.9mm、2.5±1.0mm 和 1.8±0.6mm。6 个月时完全闭塞率为 57.1%，所有患者在随访中均获得良好的结局（mRS 0-2）。无一例患者发生卒中并发症。纳入荟萃分析的 7 项研究共 1360 篇文章，包括 227 例患者的 244 个动脉瘤接受了 FRED Jr 治疗。平均动脉瘤高度、宽度、颈和母动脉直径分别为 6.9±3.3mm（合并=5.6[0.1-11.47]mm）、6.6±2.2mm（合并=6.6[4.2-9.1]mm）、4.4±1.4mm（合并=4.1[3.3-4.9]mm）和 2.0±0.2mm（合并=2.1[1.7-2.5]mm）。最终随访时，完全闭塞和并发症的合并率分别为 69.9%和 0%。
FRED Jr 在中期随访中治疗小血管母瘤的远端动脉瘤显示出中等疗效和良好的安全性。
