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

被引：20

作者：

Griessenauer, Christoph J. ^{[1
,2
]}

Enriquez-Marulanda, Alejandro ^{[3
]}

Xiang, Sissi ^{[4
]}

Hong, Tao ^{[4
]}

Zhang, Hongqi ^{[4
]}

Taussky, Philipp ^{[5
]}

Grandhi, Ramesh ^{[5
]}

Waqas, Muhammad ^{[6
]}

Tutino, Vincent M. ^{[6
]}

Siddiqui, Adnan H. ^{[6
]}

Levy, Elad, I ^{[6
]}

Ogilvy, Christopher S. ^{[7
]}

Thomas, Ajith J. ^{[7
]}

Ulfert, Christian ^{[8
]}

Moehlenbruch, Markus A. ^{[8
]}

Renieri, Leonardo ^{[9
]}

Limbucci, Nicola ^{[9
]}

Parra-Farinas, Carmen ^{[10
]}

Burkhardt, Jan-Karl ^{[11
]}

Kan, Peter ^{[11
]}

Rinaldo, Lorenzo ^{[12
]}

Lanzino, Giuseppe ^{[12
]}

Brinjikji, Waleed ^{[12
]}

Spears, Julian ^{[13
]}

Mueller-Thies-Broussalis, Erasmia ^{[2
,14
]}

Killer-Oberpfalzer, Monika ^{[2
,14
]}

Islak, Civan ^{[15
]}

Kocer, Naci ^{[15
]}

Sonnberger, Michael ^{[16
]}

Engelhorn, Tobias ^{[17
]}

Ghuman, Mandeep ^{[18
]}

Yang, Victor X. D. ^{[18
]}

Salehani, Arsalaan ^{[19
]}

Harrigan, Mark R. ^{[19
]}

Radovanovic, Ivan ^{[20
]}

Pereira, Vitor M. ^{[20
]}

Krings, Timo ^{[20
]}

Matouk, Charles C. ^{[21
]}

Chen, Karen ^{[22
]}

Aziz-Sultan, Mohammad Ali ^{[22
]}

Ghorbani, Mohammad ^{[23
]}

Schirmer, Clemens M. ^{[1
,2
]}

Goren, Oded ^{[1
]}

Dalal, Shamsher S. ^{[24
]}

Koch, Matthew J. ^{[25
]}

Stapleton, Christopher J. ^{[25
]}

Patel, Aman B. ^{[25
]}

Finkenzeller, Thomas ^{[26
]}

Holtmannspotter, Markus ^{[27
]}

Buhk, Jan Hendrik ^{[28
]}

机构：

[1] Geisinger, Dept Neurosurg, 100 N Acad Ave, Danville, PA 17821 USA

[2] Paracelsus Med Univ Salzburg, Res Inst Neurointervent, Salzburg, Austria

[3] Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA

[4] Xuanwu Hosp, Dept Neurosurg, Beijing, Peoples R China

[5] Univ Utah Hosp, Dept Neurosurg, Salt Lake City, UT USA

[6] SUNY Buffalo, Dept Neurosurg, Sch Med & Biomed Sci, Buffalo, NY USA

[7] Beth Israel Deaconess Med Ctr, Surg, Div Neurosurg, Boston, MA 02215 USA

[8] Heidelberg Univ, Dept Neuroradiol, Heidelberg, Baden Wurttembe, Germany

[9] Univ Hosp Careggi, Intervent Neuroradiol, Florence, Toscana, Italy

[10] St Michaels Hosp, Dept Radiol, Toronto, ON, Canada

[11] Baylor Coll Med, Dept Neurosurg, Houston, TX 77030 USA

[12] Mayo Clin, Dept Neurosurg, Rochester, MN USA

[13] St Michaels Hosp, Therapeut Neuroradiol & Neurosurg, Toronto, ON, Canada

[14] Paracelsus Med Privatuniv, Dept Neurol, Salzburg, Austria

[15] Istanbul Univ Cerrahpasa, Dept Radiol, Istanbul, Turkey

[16] Johannes Kepler Univ Linz, Dept Neuroradiol, Linz, Austria

[17] Friedrich Alexander Univ Erlangen Nuremberg, Dept Neuroradiol, Fac Med, Erlangen, Bayern, Germany

[18] Sunnybrook Hlth Sci Ctr, Neuroradiol & Neurosurg, Toronto, ON, Canada

[19] UAB Hosp, Dept Neurosurg, Birmingham, AL USA

[20] Toronto Western Hosp, Intervent Neuroradiol & Neurosurg, Toronto, ON, Canada

[21] Yale Univ, Dept Neurosurg, New Haven, CT USA

[22] Brigham & Womens Hosp, Neurointervent Radiol & Neurosurg, 75 Francis St, Boston, MA 02115 USA

[23] Iran Univ Med Sci, Div Vasc & Endovasc Neurosurg, Firoozgar Hosp, Tehran, Iran

[24] Geisinger Hlth Syst, Dept Radiol, Danville, PA USA

[25] Massachusetts Gen Hosp, Dept Neurosurg, Boston, MA 02114 USA

[26] Klinikum Nurnberg, Nurnberg, Bayern, Germany

[27] Rigshosp, Dept Neuroradiol, Copenhagen, Denmark

[28] Univ Klinikum Hamburg Eppendorf, Dept Diagnost & Intervent Neuroradiol, Hamburg, Germany

[29] Orlando Hlth Corp, Orlando, FL USA

[30] Univ Klinikum Saarlandes, Dept Neuroradiol, Homburg, Germany

[31] Univ Saarland, Med Fak, Homburg, Germany

[32] Nuremberg Hosp, Dept Neuroradiol, Nurnberg, Bayern, Germany

来源：

JOURNAL OF NEUROINTERVENTIONAL SURGERY | 2021年 / 13卷 / 02期

关键词：

flow diverter; aneurysm; embolic; intervention; posterior fossa;

D O I：

10.1136/neurintsurg-2020-016055

中图分类号：

R445 [影像诊断学];

学科分类号：

100207 ;

摘要：

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.

引用

页码：153 / 158

页数：6

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