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

Christoph J. Griessenauer; Alejandro Enriquez-Marulanda; Sissi Xiang; Tao Hong; Hongqi Zhang; Philipp Taussky; Ramesh Grandhi; Muhammad Waqas; Vincent M. Tutino; Adnan H. Siddiqui; Elad I. Levy; Christopher S. Ogilvy; Ajith J. Thomas; Christian Ulfert; Markus A. Möhlenbruch; Leonardo Renieri; Nicola Limbucci; Carmen Parra-Fariñas; Jan Karl Burkhardt; Peter Kan; Lorenzo Rinaldo; Giuseppe Lanzino; Waleed Brinjikji; Julian Spears; Erasmia Müller-Thies-Broussalis; Monika Killer-Oberpfalzer; Civan Islak; Naci Kocer; Michael Sonnberger; Tobias Engelhorn; Mandeep Ghuman; Victor X.D. Yang; Arsalaan Salehani; Mark R. Harrigan; Ivan Radovanovic; Vitor M. Pereira; Timo Krings; Charles C. Matouk; Karen Chen; Mohammad Ali Aziz-Sultan; Mohammad Ghorbani; Clemens M. Schirmer; Oded Goren; Shamsher S. Dalal; Matthew J. Koch; Christopher J. Stapleton; Aman B. Patel; Thomas Finkenzeller; Markus Holtmannspötter; Jan Hendrik Buhk; Paul Michael Foreman; Marshall Cress; Robert Hirschl; Wolfgang Reith; Andreas Simgen; Hendrik Janssen; Thomas R. Marotta; Adam A. Dmytriw

doi:10.1136/neurintsurg-2020-016055

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

Christoph J. Griessenauer, Alejandro Enriquez-Marulanda, Sissi Xiang, Tao Hong, Hongqi Zhang, Philipp Taussky, Ramesh Grandhi, Muhammad Waqas, Vincent M. Tutino, Adnan H. Siddiqui, Elad I. Levy, Christopher S. Ogilvy, Ajith J. Thomas, Christian Ulfert, Markus A. Möhlenbruch, Leonardo Renieri, Nicola Limbucci, Carmen Parra-Fariñas, Jan Karl Burkhardt, Peter KanLorenzo Rinaldo, Giuseppe Lanzino, Waleed Brinjikji, Julian Spears, Erasmia Müller-Thies-Broussalis, Monika Killer-Oberpfalzer, Civan Islak, Naci Kocer, Michael Sonnberger, Tobias Engelhorn, Mandeep Ghuman, Victor X.D. Yang, Arsalaan Salehani, Mark R. Harrigan, Ivan Radovanovic, Vitor M. Pereira, Timo Krings, Charles C. Matouk, Karen Chen, Mohammad Ali Aziz-Sultan, Mohammad Ghorbani, Clemens M. Schirmer, Oded Goren, Shamsher S. Dalal, Matthew J. Koch, Christopher J. Stapleton, Aman B. Patel, Thomas Finkenzeller, Markus Holtmannspötter, Jan Hendrik Buhk, Paul Michael Foreman, Marshall Cress, Robert Hirschl, Wolfgang Reith, Andreas Simgen, Hendrik Janssen, Thomas R. Marotta, Adam A. Dmytriw

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

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.

Original language	English (US)
Pages (from-to)	153-158
Number of pages	6
Journal	Journal of neurointerventional surgery
Volume	13
Issue number	2
DOIs	https://doi.org/10.1136/neurintsurg-2020-016055
State	Published - Feb 1 2021
Externally published	Yes

Keywords

aneurysm
embolic
flow diverter
intervention
posterior fossa

ASJC Scopus subject areas

Surgery
Clinical Neurology

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10.1136/neurintsurg-2020-016055

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Griessenauer, C. J., Enriquez-Marulanda, A., Xiang, S., Hong, T., Zhang, H., Taussky, P., Grandhi, R., Waqas, M., Tutino, V. M., Siddiqui, A. H., Levy, E. I., Ogilvy, C. S., Thomas, A. J., Ulfert, C., Möhlenbruch, M. A., Renieri, L., Limbucci, N., Parra-Fariñas, C., Burkhardt, J. K., ... Dmytriw, A. A. (2021). Comparison of PED and FRED flow diverters for posterior circulation aneurysms: A propensity score matched cohort study. Journal of neurointerventional surgery, 13(2), 153-158. https://doi.org/10.1136/neurintsurg-2020-016055

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, VXD, 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 2021, 'Comparison of PED and FRED flow diverters for posterior circulation aneurysms: A propensity score matched cohort study', Journal of neurointerventional surgery, vol. 13, no. 2, pp. 153-158. https://doi.org/10.1136/neurintsurg-2020-016055

@article{b1446f5124c84ca091617184e8036229,

title = "Comparison of PED and FRED flow diverters for posterior circulation aneurysms: A propensity score matched cohort study",

abstract = "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.",

keywords = "aneurysm, embolic, flow diverter, intervention, posterior fossa",

author = "Griessenauer, {Christoph J.} and Alejandro Enriquez-Marulanda and Sissi Xiang and Tao Hong and Hongqi Zhang and Philipp Taussky and Ramesh Grandhi and Muhammad Waqas and Tutino, {Vincent M.} and Siddiqui, {Adnan H.} and Levy, {Elad I.} and Ogilvy, {Christopher S.} and Thomas, {Ajith J.} and Christian Ulfert and M{\"o}hlenbruch, {Markus A.} and Leonardo Renieri and Nicola Limbucci and Carmen Parra-Fari{\~n}as and Burkhardt, {Jan Karl} and Peter Kan and Lorenzo Rinaldo and Giuseppe Lanzino and Waleed Brinjikji and Julian Spears and Erasmia M{\"u}ller-Thies-Broussalis and Monika Killer-Oberpfalzer and Civan Islak and Naci Kocer and Michael Sonnberger and Tobias Engelhorn and Mandeep Ghuman and Yang, {Victor X.D.} and Arsalaan Salehani and Harrigan, {Mark R.} and Ivan Radovanovic and Pereira, {Vitor M.} and Timo Krings and Matouk, {Charles C.} and Karen Chen and Aziz-Sultan, {Mohammad Ali} and Mohammad Ghorbani and Schirmer, {Clemens M.} and Oded Goren and Dalal, {Shamsher S.} and Koch, {Matthew J.} and Stapleton, {Christopher J.} and Patel, {Aman B.} and Thomas Finkenzeller and Markus Holtmannsp{\"o}tter and Buhk, {Jan Hendrik} and Foreman, {Paul Michael} and Marshall Cress and Robert Hirschl and Wolfgang Reith and Andreas Simgen and Hendrik Janssen and Marotta, {Thomas R.} and Dmytriw, {Adam A.}",

year = "2021",

month = feb,

day = "1",

doi = "10.1136/neurintsurg-2020-016055",

language = "English (US)",

volume = "13",

pages = "153--158",

journal = "Journal of neurointerventional surgery",

issn = "1759-8478",

publisher = "BMJ Publishing Group",

number = "2",

}

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.

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 -

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

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