Endovascular treatment of challenging aneurysms with FRED Jr flow diverter stents: a single-center experience

Sayın, Bige; Şenol, Yiğit Can; Dağlıoğlu, Ergün; Özbakır, Musa Onur; Orhan, Gürdal; Akmangit, İlkay

doi:10.1007/s11604-022-01354-2

Cited by 2 publications

(1 citation statement)

References 38 publications

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“…For aneurysm occlusion, good OKM grades (grade C and D) indicate good occlusion and treatment effect. For the FRED flow diverter, the complete aneurysm occlusion (grade D) rate has been reported to range from 66 to 87% or even 100%, with the complete occlusion rate being continuously increased with extension of the follow-up time 27 – 29 . In reporting angiographic follow-up outcomes of 71 patients with 77 large or giant cerebral aneurysms treated with the Pipeline flow diverter (excluding 7 patients with parent artery occlusion) 30 , complete aneurysm occlusion (OKM grade D) was achieved in 64.9% aneurysms 6 months after embolization, 76.6% after 1 year, and 77.9% at 3-years follow-up, with the trend of occlusion being gradually increased over time.…”

Section: Discussionmentioning

confidence: 99%

Use of the Tubridge flow diverter in the treatment of intracranial aneurysms: a single center experience

Li,

Gao,

et al. 2024

Sci Rep

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To investigate the safety and effect of Tubridge flow diverter deployment for the treatment of intracranial aneurysms, 85 patients with intracranial aneurysms treated with the Tubridge flow diverter were retrospectively enrolled. The clinical data including the baseline data, aneurysm parameters before and after treatment, and follow-up outcomes were assessed. Among 85 patients, there were 35 (41.2%) males and 50 females (58.8%) aged 17–77 (mean 56.7 ± 11.1) years with 110 aneurysms. Five (5.9%) patients initially presented with subarachnoid hemorrhage from aneurysm rupture. The aneurysm size was 2–30 (mean 8.6) mm, and the aneurysm neck was 2–10.6 (mean 5.7 ± 2.3) mm. Ninety-three Tubridge stents were deployed. Twenty-five (29.4%) patients experienced adjunctive loose coiling. Blood flow was significantly reduced from entering the aneurysm after stent deployment. Periprocedural complications occurred in three (3.5%) patients, including in-stent thrombosis during embolization in one patient (1.2%), conjunctiva edema on the right in one patient (1.2%), and acute multiple cerebral infarctions in one patient (1.2%). Angiographic follow-up was conducted in 67 (78.8%) patients 3–36 (mean 15.3 ± 5.6) months later. In 11 (16.4% or 11/67) patients, blood flow still entered the aneurysm with the O’Kelly-Marotta (OKM) grade B in two (3.0%) patients and grade C in nine (13.4%), whereas complete occlusion (OKM grade D) was achieved in the other 56 (83.6% or 56/67) aneurysms. In-stent stenosis was present in five (7.5%) patients with approximately 25% stenosis in three (4.5%) patients and 50% in two (3.0%). In conclusion, the Tubridge flow diverter can be safely and efficiently applied in the treatment of small and large intracranial aneurysms, with a low periprocedural complication rate, a high occlusion degree, and a low in-stent stenosis rate at follow-up even though large aneurysms may necessitate a longer surgical time and adjunctive coiling.

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Section: Discussionmentioning

confidence: 99%

Use of the Tubridge flow diverter in the treatment of intracranial aneurysms: a single center experience

Li,

Gao,

et al. 2024

Sci Rep

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The safety profile of single antiplatelet therapy with flow diverters: Systematic review and meta-analysis

et al. 2023

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Background Dual antiplatelet therapy (DAPT) is frequently used in treating cerebral aneurysms with flow diverters (FDs), whereas single antiplatelet therapy (SAPT) is used mostly with coated FDs and in ruptured aneurysms. We conducted a systematic review and meta-analysis to explore the safety profile of SAPT in FDs. Methods PubMed, Web of Science, OVID Embase, OVID Medline, and Scopus were searched to 1st November 2022. Outcomes of interest included ischemic and hemorrhagic complications, conversion to DAPTs, and in-stent stenosis rates under long-term SAPT. SAPT is divided into aspirin (ASA) vs. non-ASA group (ticagrelor or prasugrel). Subgroup analysis was performed for ruptured vs. non-ruptured aneurysms and coated vs. non-coated FDs. All data were analyzed using R software version 4.2.2. Results Twelve studies with 240 total patients (43 patients in the ASA group and 197 patients in the non-ASA group) were included in our meta-analysis. The pooled ischemic occlusion rate was 9.8% (95% CI = 4.87−18.95: p-value = 0.09) for SAPTs. The ASA group had significantly higher ischemic complication rates compared to the non-ASA group (20.8% vs. 6.3%, respectively, p-value = 0.02). The pooled hemorrhagic complication rate was 3.5% (95% CI = 1.38−8.81: p-value > 0.99). The hemorrhagic rates of ASA group were 9.3%% (95% CI = 3.54−22.30) over the non-ASA group 2.1% (95% CI = 0.58−7.54) ( p-value > 0.99). The overall in-stent stenosis rate was 2.3% (95% CI = 1.06−5.14: p-value > 0.99). The ischemic complication rates were comparable between coated vs non-coated FDs (10.7% vs. 5.5% p-value = 0.39). In stent stenosis rate were 1.9% (95% CI = 0.72−4.96) in coated FDs over 4.4% (95% CI = 1.11−16.11) ( p-value = 0.32). The ruptured and non-ruptured groups also showed comparable results in terms of ischemic (17.6% vs. 7.1% respectively, p-value = 0.24) and hemorrhagic complications (9.8% vs. 1.1%, respectively, p-value = 0.08). Conclusions Flow diverter treatment under ASA monotherapy resulted in relatively high ischemic complication rates. However, SAPT with prasugrel or ticagrelor monotherapy is promising for coated FDs and ruptured aneurysm treatments. Given the overall small sample size and also the likely presence of known and unknown biases regarding choice of antiplatelet therapy between groups, larger cohort studies are needed to evaluate SAPT treatment outcomes.

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Endovascular treatment of challenging aneurysms with FRED Jr flow diverter stents: a single-center experience

Cited by 2 publications

References 38 publications

Use of the Tubridge flow diverter in the treatment of intracranial aneurysms: a single center experience

Use of the Tubridge flow diverter in the treatment of intracranial aneurysms: a single center experience

The safety profile of single antiplatelet therapy with flow diverters: Systematic review and meta-analysis

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