Flow Diverter Treatment Using a Flow Re-Direction Endoluminal Device for Unruptured Intracranial Vertebral Artery...

Area of Science:

• Endovascular neurosurgery
• Cerebrovascular disease
• Medical device technology

Background:

• Unruptured intracranial vertebral artery dissecting aneurysms (VADAs) pose a risk of stroke.
• Flow diverter (FD) devices offer a minimally invasive treatment option.
• The Flow Re-direction Endoluminal Device (FRED) is a specific FD used for aneurysm treatment.

Purpose of the Study:

• To evaluate the effectiveness and safety of FRED for unruptured VADAs.
• To assess technical considerations and outcomes of FRED treatment.
• To analyze factors influencing treatment success in different VA anatomical contexts.

Main Methods:

• Retrospective analysis of 23 patients with unruptured VADAs treated with FRED devices (FRED or FRED Jr.).
• Evaluation of clinical and angiographic outcomes, including occlusion rates and complications.
• Categorization of dissections based on vertebral artery (VA) dominance: dominant, co-dominant, and non-dominant.

Main Results:

• Successful FD treatment was achieved in all patients.
• Complete occlusion rates reached 78.3% at 6 months and 91.3% at 12 months.
• No complications, recurrences, or retreatment were observed during a median 20-month follow-up. Technical difficulties occurred in 4 cases involving non-dominant VAs.

Conclusions:

• Flow diversion with FRED is a feasible and safe treatment for unruptured VADAs.
• Satisfactory occlusion rates were achieved, indicating treatment efficacy.
• Technical challenges are more probable in non-dominant VAs, particularly with intraluminal lesions.