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Archives of Neurosurgery

Corresponding Author

Omar Pichardo

Mailing address: Av Instituto Politécnico Nacional 1669, Revolución IMSS, Gustavo A. Madero, 07300 Ciudad de México, CDMX

Mail: omar.pichardo.md@gmail.com

Orcid: https://orcid.org/0000-0002-1248-1097

Document Type

Original Research - Endovascular Therapy

Abstract

Background: The Flow Diverters are devices derived from brain stents, made up of a network of microfilaments of various materials that allow the vessel remodeling. The Pipeline Embolization Device and The Flow Re-Direction Endoluminal Device are the two devices with more global clinical experience. Our objective is to compare the 1-year results using these devices in a cohort of patients assessing their occlusion rate and their clinical outcome as by the modified Rankin Score (mRS).

Methods: In this retrospective nested case-control cohort study, we reviewed the medical records of patients undergoing treatment with a Flow Diverter stent for brain aneurysms with a 1-year follow up. We considered the following inclusion criteria: patients between 18 and 80 years of age, with at least one cerebral aneurysm and aneurysms in the segments of the internal carotid artery and vertebral arteries. We recorded the clinical presentation as subarachnoid hemorrhage, headache, mass effect, transient ischemic attack, family history, and incidentals. Demographic data, topography, quantity, and lateralization of all aneurysms were collected.

Results: A total of 91 patients were included in the final analysis. The 6-month occlusion rate was 91.5% for PED and 95.7% for FRED 95.7% (p 0.597); and at 12 months it was 95.7% for PED and 97.7 for FRED (p 0.555). In pairing the propensity score (PPS) the complete occlusion rate was 90% for PED and 100% for FRED, without statistical significance in the difference at 12 months (p 0.631).

Conclusion: Flow diversion devices PED and FRED are an efficient treatment for aneurysms of the anterior circulation and some of the posterior circulation (vertebral arteries), showing similar occlusion rates and clinical outcomes.

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This work is licensed under a Creative Commons Attribution 4.0 License.

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