Professor of Neurosurgery, Director Cerebrovascular & Endovascular Fellowship Thomas Jefferson University Hospital Philadelphia, Pennsylvania, United States
Introduction: Flow diversion introduced a paradigm shift in the treatment of intracranial aneurysms. The new FRED-X stent is the latest update of the recent FDA approved FRED stent. The FRED-X is engineered to reduce material thrombogenicity and enhance vessel healing. We wanted to evaluate the feasibility and early safety and efficacy of the new FRED-X flow diversion stent
Methods: We retrospectively collected and analyzed data from patients who received flow diversion with the new FRED-X stent from four tertiary-care cerebrovascular centers in the Unites States from February 2022 through July 2022
Results: We had a total of 44 patients harboring 45 aneurysms. The mean age was 57.7 years, and most patients were female (82%). 91% of aneurysms were saccular with the majority (93%) located in the anterior circulation, specifically in the posterior communicating (27%) and carotid ophthalmic (27%) territories. The mean largest aneurysmal dimension was 5.6 mm (5.6 +/- 4.6), and 20% were previously treated. The mean procedure duration was 61.6 minutes with a mean cumulative fluoroscopy time of 24.6 minutes. Additionally, 6% received adjunct treatment. Stent placement was successful in 100% of cases, achieving good wall apposition and complete neck coverage. Further, immediate aneurysmal contrast stasis >90% was observed in 62% of cases. Moreover, 73% of cases were completed via the transfemoral route. Symptomatic postoperative complications occurred in 4 patients; 3 had transient neurological deficits, and 1 had an access site complication. All patients were discharged on dual antiplatelet regimens with an mRS of 0
Conclusion : FRED-X flow diversion for the treatment of intracranial aneurysm is technically feasible alone or in conjunction with intrasaccular embolization. In addition, our results show very promising early safety and efficacy. Follow-up studies should establish the long-term safety and efficacy profiles of this new stent.
