Long-term Follow-up After Aneurysm Treatment with the Flow Redirection Endoluminal Device (FRED) Flow Diverter,Clinical Neuroradiology

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Long-term Follow-up After Aneurysm Treatment with the Flow Redirection Endoluminal Device (FRED) Flow Diverter
Clinical Neuroradiology ( IF 2.4 ) Pub Date : 2023-10-13 , DOI: 10.1007/s00062-023-01346-3
Sophia Hohenstatt ₁ , Christian Ulfert ₁ , Christian Herweh ₁ , Tim Hilgenfeld ₁ , Niclas Schmitt ₁ , Silvia Schönenberger ₂ , Min Chen ₂ , Martin Bendszus ₁ , Markus A Möhlenbruch ₁ , Dominik F Vollherbst ₁

Affiliation

Introduction

This study focuses on long-term outcomes after aneurysm treatment with either the Flow Re-Direction Endoluminal Device (FRED) or the FRED Jr. to investigate the durability of treatment effect and long-term complications.

Methods

This study is based on a retrospective analysis of a prospectively maintained patient data base. Patients treated with either FRED or FRED Jr. between 2013 and 2017 at our institution, and thus a possibility for ≥ 5 years of follow-up, were included. Aneurysm occlusion rates, recurrence rates, modified Rankin scale score shifts to baseline, and delayed complications were assessed.

Results

In this study 68 patients with 84 aneurysms had long-term follow-up with a mean duration of 57.3 months and 44 patients harboring 52 aneurysms had a follow-up ≥ 5 years with a mean follow-up period of 69.2 months. Complete occlusion was reached in 77.4% at 2 years and increased to 84.9% when the latest available imaging result was considered. Younger age and the absence of branch involvement were predictors for aneurysm occlusion in linear regression analysis. After the 2‑year threshold, there were 3 reported symptomatic non-serious adverse events. Of these, one patient had a minor stroke, one a transitory ischemic attack and one had persistent mass effect symptoms due to a giant aneurysm, none of these resulted in subsequent neurological disability.

Conclusion

This long-term follow-up study demonstrates that the FRED and FRED Jr. are safe and effective for the treatment of cerebral aneurysms in the long term, with high rates of complete occlusion and low rates of delayed adverse events.

中文翻译：

使用血流重定向腔内装置 (FRED) 分流器治疗动脉瘤后的长期随访

介绍

本研究重点关注使用血流重定向腔内装置 (FRED) 或 FRED Jr. 治疗动脉瘤后的长期结果，以研究治疗效果的持久性和长期并发症。

方法

这项研究基于对前瞻性维护的患者数据库的回顾性分析。 2013 年至 2017 年期间在我们机构接受 FRED 或 FRED Jr. 治疗的患者，因此有可能进行 ≥ 5 年的随访。评估了动脉瘤闭塞率、复发率、改良Rankin量表评分转移至基线以及延迟并发症。

结果

在这项研究中，68 名患有 84 个动脉瘤的患者接受了长期随访，平均随访时间为 57.3 个月；44 名患有 52 个动脉瘤的患者接受了≥ 5 年的随访，平均随访时间为 69.2 个月。 2 年时完全闭塞率为 77.4%，考虑到最新的可用成像结果后，完全闭塞率增至 84.9%。在线性回归分析中，年龄较小和没有分支受累是动脉瘤闭塞的预测因素。 2 年阈值后，报告了 3 起有症状的非严重不良事件。其中，一名患者患有轻微中风，一名患者患有短暂性脑缺血发作，一名患者因巨大动脉瘤而出现持续性占位效应症状，但这些患者均未导致随后的神经功能障碍。