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Lower-ischemic-risk profile of coated flow redirection endoluminal device X compared with uncoated flow redirection endoluminal device flow diverter in the treatment of unruptured intracranial aneurysms

BACKGROUND AND OBJECTIVES: - Flow Redirection Endoluminal Device (FRED) X is a new generation flow diverter with an antithrombotic surface coating. This study compares the procedural safety and short-term efficacy of FRED X with its uncoated predecessor, the FRED. - METHODS: -...

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Main Authors: Görtz, Lukas (Author) , Hohenstatt, Sophia (Author) , Vollherbst, Dominik (Author) , Styczen, Hanna (Author) , Siebert, Eberhard (Author) , Bohner, Georg (Author) , Deuschl, Cornelius (Author) , Möhlenbruch, Markus Alfred (Author) , Kabbasch, Christoph (Author)
Format: Article (Journal)
Language:English
Published: May 2025
In: Neurosurgery
Year: 2025, Volume: 96, Issue: 5, Pages: 997-1007
ISSN:1524-4040
DOI:10.1227/neu.0000000000003188
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1227/neu.0000000000003188
Verlag, lizenzpflichtig, Volltext: https://journals.lww.com/neurosurgery/fulltext/2025/05000/lower_ischemic_risk_profile_of_coated_flow.10.aspx
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Author Notes:Lukas Goertz, MD, Sophia Hohenstatt, MD, Dominik F. Vollherbst, MD, Hanna Styczen, MD, Eberhard Siebert, MD, Georg Bohner, MD, Cornelius Deuschl, MD, Markus A. Möhlenbruch, MD, Christoph Kabbasch, MD
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Summary:BACKGROUND AND OBJECTIVES: - Flow Redirection Endoluminal Device (FRED) X is a new generation flow diverter with an antithrombotic surface coating. This study compares the procedural safety and short-term efficacy of FRED X with its uncoated predecessor, the FRED. - METHODS: - Patients treated with FRED and FRED X devices for unruptured aneurysms between 2013 and 2023 at 3 neurovascular centers were retrospectively reviewed. The procedural ischemic event rate was the safety end point, and the complete aneurysm occlusion rate at 1 year was the efficacy end point. Multivariable regression adjustment and 1:1 propensity score matching were performed to control for potential confounding. - RESULTS: - The FRED X group (137 patients) had a higher prevalence of recurrent and bifurcation aneurysms and fewer aneurysms with branch involvement than the FRED X group (156 patients). The ischemic event rate was lower in FRED X (1/156 [0.6%]) than in FRED (7/137 [5.1%]), which was significant after multivariable adjustment (odds ratio: 8.8, 95% CI: 1.1-72.7, P = .04), and tended to be significant in the propensity score analysis (P = .07). Morbidity was comparable between FRED (2.2%) and FRED X (0%, P = .10). The complete occlusion rates of FRED vs FRED X were 73/117 (62.4%) vs 39/54 (72.2%) aneurysms at 6 months (P = .21) and 52/74 (70.3%) vs 27/37 (73.0%) at 12 months (P = .77). Hemorrhagic complications, in-stent stenosis, and clinical events during follow-up and retreatments were not significantly different between groups. - CONCLUSION: - This study indicates an improved ischemic risk profile of FRED X while maintaining a favorable efficacy profile, warranting further study and translation into clinical use.
Item Description:Online veröffentlicht: 8. Oktober 2024
Gesehen am 02.10.2025
Physical Description:Online Resource
ISSN:1524-4040
DOI:10.1227/neu.0000000000003188

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