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Research ArticleInterventional

The FRED for Cerebral Aneurysms of the Posterior Circulation: A Subgroup Analysis of the EuFRED Registry

C.J. Griessenauer, M.A. Möhlenbruch, P. Hendrix, C. Ulfert, C. Islak, M. Sonnberger, T. Engelhorn, E. Müller-Thies-Broussalis, T. Finkenzeller, M. Holtmannspötter, J.-H. Buhk, W. Reith, A. Simgen, H. Janssen, N. Kocer and M. Killer-Oberpfalzer
American Journal of Neuroradiology April 2020, 41 (4) 658-662; DOI: https://doi.org/10.3174/ajnr.A6447
C.J. Griessenauer
aFrom the Research Institute of Neurointervention (C.J.G., E.M.-T.-B., M.K.-O.), Paracelsus Medical University, Salzburg, Austria
bDepartment of Neurosurgery (C.J.G.), Geisinger, Danville, Pennsylvania
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M.A. Möhlenbruch
cDepartment of Neuroradiology (M.A.M., C.U.), Heidelberg University Hospital, Heidelberg, Germany
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P. Hendrix
dDepartment of Neurosurgery (P.H.), Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg/Saar, Germany
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C. Ulfert
cDepartment of Neuroradiology (M.A.M., C.U.), Heidelberg University Hospital, Heidelberg, Germany
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C. Islak
eDepartment of Neuroradiology (C.I., N.K.), Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey
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M. Sonnberger
fDepartment of Neuroradiology (M.S.), Kepler Universitätsklinikum, Linz, Austria
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T. Engelhorn
gDepartment of Neuroradiology (T.E.), University Hospital Erlangen, Erlangen, Germany
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E. Müller-Thies-Broussalis
aFrom the Research Institute of Neurointervention (C.J.G., E.M.-T.-B., M.K.-O.), Paracelsus Medical University, Salzburg, Austria
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T. Finkenzeller
hInstitute of Radiology and Neuroradiology (T.F., M.H.), Klinikum Nuernberg Sued, Paracelsus Medical University, Nuernberg, Germany
iDepartment of Neuroradiology (T.F.), Klinikum Weiden, Weiden, Bavaria, Germany
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M. Holtmannspötter
hInstitute of Radiology and Neuroradiology (T.F., M.H.), Klinikum Nuernberg Sued, Paracelsus Medical University, Nuernberg, Germany
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J.-H. Buhk
jDepartment of Neuroradiology (J.-H.B.), University Hospital Hamburg Eppendorf, Hamburg, Germany
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W. Reith
kClinic for Diagnostic and Interventional Neuroradiology (W.R., A.S.), Universitätsklinikum des Saarlandes, Homburg/Saar, Homburg, Saarland, Germany
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A. Simgen
kClinic for Diagnostic and Interventional Neuroradiology (W.R., A.S.), Universitätsklinikum des Saarlandes, Homburg/Saar, Homburg, Saarland, Germany
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H. Janssen
lInstitute for Neuroradiology (H.J.), Klinikum Ingolstadt, Ingolstadt, Germany.
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N. Kocer
eDepartment of Neuroradiology (C.I., N.K.), Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey
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M. Killer-Oberpfalzer
aFrom the Research Institute of Neurointervention (C.J.G., E.M.-T.-B., M.K.-O.), Paracelsus Medical University, Salzburg, Austria
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Abstract

BACKGROUND AND PURPOSE: Flow diversion for the posterior circulation remains a promising treatment option for selected posterior circulation aneurysms. The Flow-Redirection Intraluminal Device (FRED) system has not been previously assessed in a large cohort of patients with posterior circulation aneurysms. The purpose of the present study was to assess safety and efficacy of FRED in this location.

MATERIALS AND METHODS: Consecutive patients with posterior circulation aneurysms treated at 8 centers participating in the European FRED study (EuFRED) between April 2012 and January 2019 were retrospectively reviewed. Complication and radiographic and functional outcomes were evaluated.

RESULTS: Eighty-four patients (median age, 54 years) with 84 posterior circulation aneurysms were treated with the FRED. A total of 25 aneurysms (29.8%) had previously ruptured, even though most aneurysms were diagnosed incidentally (45.2%). The intradural vertebral artery was the most common location (50%), and saccular, the most common morphology (40.5%). The median size was 7 mm. There were 8 (9.5%) symptomatic thromboembolic and no hemorrhagic complications. Thromboembolic complications occurred mostly (90.9%) in nonsaccular aneurysms. On last follow-up at a median of 24 months, 78.2% of aneurysms were completely occluded. Functional outcome at a median of 27 months was favorable in 94% of patients. All mortalities occurred in patients with acute subarachnoid hemorrhage and its sequelae.

CONCLUSIONS: The largest cohort of posterior circulation aneurysms treated with the FRED to date demonstrated favorable safety and efficacy profiles of the device for this indication. Treatment in the setting of acute subarachnoid hemorrhage was strongly related to mortality, regardless of whether procedural complications occurred.

  • © 2020 by American Journal of Neuroradiology
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American Journal of Neuroradiology: 41 (4)
American Journal of Neuroradiology
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The FRED for Cerebral Aneurysms of the Posterior Circulation: A Subgroup Analysis of the EuFRED Registry
C.J. Griessenauer, M.A. Möhlenbruch, P. Hendrix, C. Ulfert, C. Islak, M. Sonnberger, T. Engelhorn, E. Müller-Thies-Broussalis, T. Finkenzeller, M. Holtmannspötter, J.-H. Buhk, W. Reith, A. Simgen, H. Janssen, N. Kocer, M. Killer-Oberpfalzer
American Journal of Neuroradiology Apr 2020, 41 (4) 658-662; DOI: 10.3174/ajnr.A6447

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The FRED for Cerebral Aneurysms of the Posterior Circulation: A Subgroup Analysis of the EuFRED Registry
C.J. Griessenauer, M.A. Möhlenbruch, P. Hendrix, C. Ulfert, C. Islak, M. Sonnberger, T. Engelhorn, E. Müller-Thies-Broussalis, T. Finkenzeller, M. Holtmannspötter, J.-H. Buhk, W. Reith, A. Simgen, H. Janssen, N. Kocer, M. Killer-Oberpfalzer
American Journal of Neuroradiology Apr 2020, 41 (4) 658-662; DOI: 10.3174/ajnr.A6447
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