Comparison of ped and fred flow diverters for posterior circulation aneurysms: a propensity score matched cohort study

Griessenauer CJ, Enriquez-Marulanda A, Xiang S, Hong T, Zhang H, Taussky P, Grandhi R, Waqas M, Tutino VM, Siddiqui AH, Levy EI, Ogilvy CS, Thomas AJ, Ulfert C, Möhlenbruch MA, Renieri L, Limbucci N, Parra-Fariñas C, Burkhardt JK, Kan P, Rinaldo L, Lanzino G, Brinjikji W, Spears J, Müller-Thies-Broussalis E, Killer-Oberpfalzer M, Islak C, Kocer N, Sonnberger M, Engelhorn T, Ghuman M, Yang VX, Salehani A, Harrigan MR, Radovanovic I, Pereira VM, Krings T, Matouk CC, Chen K, Aziz-Sultan MA, Ghorbani M, Schirmer CM, Goren O, Dalal SS, Koch MJ, Stapleton CJ, Patel AB, Finkenzeller T, Holtmannspötter M, Buhk JH, Foreman PM, Cress M, Hirschl R, Reith W, Simgen A, Janssen H, Marotta TR, Dmytriw AA (2020)

Publication Type: Journal article

Publication year: 2020

Journal

DOI: 10.1136/neurintsurg-2020-016055

Abstract

Background: 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.

Authors with CRIS profile

Involved external institutions

Beijing Xuanwu Hospital China (CN) University at Buffalo. State University of New York United States (USA) (US) Beth Israel Deaconess Medical Center (BIDMC) United States (USA) (US) University of Utah Hospital United States (USA) (US) Ruprecht-Karls-Universität Heidelberg Germany (DE) Careggi University Hospital / Azienda Ospedaliero Universitaria Careggi Italy (IT) St. Michael's Hospital Canada (CA) Baylor College of Medicine United States (USA) (US) Mayo Clinic United States (USA) (US) Istanbul University Cerrahpaşa / İstanbul Üniversitesi Cerrahpaşa (IUC) Turkey (TR) Johannes Kepler Universität (JKU) Linz Austria (AT) Sunnybrook Health Sciences Centre Canada (CA) UAB Hospital (University of Alabama at Birmingham Hospital) United States (USA) (US) University of Toronto Canada (CA) Yale University United States (USA) (US) Brigham and Women's Hospital (BWH) United States (USA) (US) Firoozgar General Hospital / بیمارستان آموزشی و درمانی فیروزگر Iran, Islamic Republic of (IR) Geisinger Health System United States (USA) (US) Massachusetts General Hospital United States (USA) (US) Klinikum Nürnberg Germany (DE) Rigshospitalet Denmark (DK) Universitätsklinikum Hamburg-Eppendorf (UKE) Germany (DE) Orlando Health United States (USA) (US) Universität des Saarlandes (UdS) Germany (DE)

How to cite

APA:

Griessenauer, C.J., Enriquez-Marulanda, A., Xiang, S., Hong, T., Zhang, H., Taussky, P.,... Dmytriw, A.A. (2020). Comparison of ped and fred flow diverters for posterior circulation aneurysms: a propensity score matched cohort study. Journal of Neurointerventional Surgery. https://doi.org/10.1136/neurintsurg-2020-016055

MLA:

Griessenauer, Christoph J., et al. "Comparison of ped and fred flow diverters for posterior circulation aneurysms: a propensity score matched cohort study." Journal of Neurointerventional Surgery (2020).

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