TY - JOUR
T1 - Comparison of PED and FRED flow diverters for posterior circulation aneurysms
T2 - A propensity score matched cohort study
AU - Griessenauer, Christoph J.
AU - Enriquez-Marulanda, Alejandro
AU - Xiang, Sissi
AU - Hong, Tao
AU - Zhang, Hongqi
AU - Taussky, Philipp
AU - Grandhi, Ramesh
AU - Waqas, Muhammad
AU - Tutino, Vincent M.
AU - Siddiqui, Adnan H.
AU - Levy, Elad I.
AU - Ogilvy, Christopher S.
AU - Thomas, Ajith J.
AU - Ulfert, Christian
AU - Möhlenbruch, Markus A.
AU - Renieri, Leonardo
AU - Limbucci, Nicola
AU - Parra-Fariñas, Carmen
AU - Burkhardt, Jan Karl
AU - Kan, Peter
AU - Rinaldo, Lorenzo
AU - Lanzino, Giuseppe
AU - Brinjikji, Waleed
AU - Spears, Julian
AU - Müller-Thies-Broussalis, Erasmia
AU - Killer-Oberpfalzer, Monika
AU - Islak, Civan
AU - Kocer, Naci
AU - Sonnberger, Michael
AU - Engelhorn, Tobias
AU - Ghuman, Mandeep
AU - Yang, Victor X.D.
AU - Salehani, Arsalaan
AU - Harrigan, Mark R.
AU - Radovanovic, Ivan
AU - Pereira, Vitor M.
AU - Krings, Timo
AU - Matouk, Charles C.
AU - Chen, Karen
AU - Aziz-Sultan, Mohammad Ali
AU - Ghorbani, Mohammad
AU - Schirmer, Clemens M.
AU - Goren, Oded
AU - Dalal, Shamsher S.
AU - Koch, Matthew J.
AU - Stapleton, Christopher J.
AU - Patel, Aman B.
AU - Finkenzeller, Thomas
AU - Holtmannspötter, Markus
AU - Buhk, Jan Hendrik
AU - Foreman, Paul Michael
AU - Cress, Marshall
AU - Hirschl, Robert
AU - Reith, Wolfgang
AU - Simgen, Andreas
AU - Janssen, Hendrik
AU - Marotta, Thomas R.
AU - Dmytriw, Adam A.
N1 - Funding Information:
Competing interests Ajith Thomas: DSMB SCENT trial by STRYKER. Funds paid to institution. Ramesh Grandhi: Consultant for Medtronic neurovascular, BALT neurovascular and Cerenovus. Christoph Griessenauer: Consultant for Stryker and received research funding from Medtronic. Naci Kocer: Consultant and proctoring agreement with MicroVention. Philipp Taussky:Reply: Consultant for Medtronic, Stryker, Cerenovus. Peter Kan: Consultant for Stryker, Medtronic, MicroVention, and Cerenovus. Vincent Tutino: Co-founder of Neurovascular Diagnostics, Inc. Monika Killer: Research grant from MicroVention/Terumo. Waleed Brinjikji: Microvention and Cerenovus consultant. Tom Marotta: Medtronic proctoring. Timo Krings: Consultant for Stryker, Medtronic, Penumbra, Cerenovus. stockholder in Marblehead Inc, royalties from Thieme. Clemens Schirmer: Research Support from Penumbra. Shareholder in Neurotechnology Investors. Giuseppe Lanzino: Consultant for Superior Medical Editing and Nested Knowledge. Christian Ulfert: Consulting fees from Johnson & Johnson. Charles Matouk: Consultant for Medtronic, Penumbra, Silk Road Medical Markus Mohlenbruch: Consultant for Medtronic, MicroVention, Stryker. Grants/grants pending: Balt (money paid to the institution), MicroVention (money paid to the institution). Payment for lectures includings service on speakers bureaus: Medtronic, MicroVention, and Stryker. Marshall Cress: Consulting for Cannon and Cerenovus.None related to this study and none are declared for the reminder of the authors.
Publisher Copyright:
© 2021 BMJ Publishing Group. All rights reserved.
PY - 2021/2/1
Y1 - 2021/2/1
N2 - AbstractBackground Flow diversion is a common endovascular treatment for cerebral aneurysms, but studies comparing different types of flow diverters are scarce. Objective To perform a propensity score matched cohort study comparing the Pipeline Embolization Device (PED) and Flow Redirection Intraluminal Device (FRED) for posterior circulation aneurysms. Methods Consecutive aneurysms of the posterior circulation treated at 25 neurovascular centers with either PED or FRED were collected. Propensity score matching was used to control for age, duration of follow-up imaging, adjunctive coiling, and aneurysm location, size, and morphology; previously ruptured aneurysms were excluded. The two devices were compared for the following outcomes: procedural complications, aneurysm occlusion, and functional outcome. Results A total of 375 aneurysms of the posterior circulation were treated in 369 patients. The PED was used in 285 (77.2%) and FRED in 84 (22.8%) procedures. Aneurysms treated with the PED were more commonly fusiform and larger than those treated with FRED. To account for these important differences, propensity score matching was performed resulting in 33 PED and FRED unruptured aneurysm pairs. No differences were found in occlusion status and neurologic thromboembolic or hemorrhagic complications between the two devices. The proportion of patients with favorable functional outcome was higher with FRED (100% vs 87.9%, p=0.04). Conclusion Comparative analysis of PED and FRED for the treatment of unruptured posterior circulation aneurysms did not identify significant differences in aneurysm occlusion or neurologic complications. Variations in functional outcomes warrant additional investigations.
AB - AbstractBackground Flow diversion is a common endovascular treatment for cerebral aneurysms, but studies comparing different types of flow diverters are scarce. Objective To perform a propensity score matched cohort study comparing the Pipeline Embolization Device (PED) and Flow Redirection Intraluminal Device (FRED) for posterior circulation aneurysms. Methods Consecutive aneurysms of the posterior circulation treated at 25 neurovascular centers with either PED or FRED were collected. Propensity score matching was used to control for age, duration of follow-up imaging, adjunctive coiling, and aneurysm location, size, and morphology; previously ruptured aneurysms were excluded. The two devices were compared for the following outcomes: procedural complications, aneurysm occlusion, and functional outcome. Results A total of 375 aneurysms of the posterior circulation were treated in 369 patients. The PED was used in 285 (77.2%) and FRED in 84 (22.8%) procedures. Aneurysms treated with the PED were more commonly fusiform and larger than those treated with FRED. To account for these important differences, propensity score matching was performed resulting in 33 PED and FRED unruptured aneurysm pairs. No differences were found in occlusion status and neurologic thromboembolic or hemorrhagic complications between the two devices. The proportion of patients with favorable functional outcome was higher with FRED (100% vs 87.9%, p=0.04). Conclusion Comparative analysis of PED and FRED for the treatment of unruptured posterior circulation aneurysms did not identify significant differences in aneurysm occlusion or neurologic complications. Variations in functional outcomes warrant additional investigations.
KW - aneurysm
KW - embolic
KW - flow diverter
KW - intervention
KW - posterior fossa
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U2 - 10.1136/neurintsurg-2020-016055
DO - 10.1136/neurintsurg-2020-016055
M3 - Article
C2 - 32611622
AN - SCOPUS:85088392558
SN - 1759-8478
VL - 13
SP - 153
EP - 158
JO - Journal of neurointerventional surgery
JF - Journal of neurointerventional surgery
IS - 2
ER -