Pipeline Embolization Device and Flow Re-Direction Endoluminal Device for Intracranial Aneurysms: A Comparative...

Area of Science:

• Neurosurgery
• Endovascular Therapy
• Cerebrovascular Disease

Background:

• Intracranial aneurysms require advanced treatment options.
• Flow diversion is a developing endovascular technique.
• Comparing FRED and PED devices is essential for treatment selection.

Purpose of the Study:

• To systematically compare the Flow Re-Direction Endoluminal Device (FRED) and Pipeline Embolization Device (PED).
• To evaluate the efficacy and safety of FRED versus PED in treating intracranial aneurysms.

Main Methods:

• Systematic review and meta-analysis following PRISMA guidelines.
• Searched PubMed, Scopus, Web of Science, and Embase databases.
• Included double-arm studies comparing FRED and PED up to October 2023.

Main Results:

• 1769 patients included; 973 received FRED, 651 received PED.
• No significant difference in complete occlusion rates at 6 months, 1 year, or last follow-up.
• FRED showed significantly higher rates of good modified Rankin Scale scores; PED had higher hemorrhage and re-treatment rates.

Conclusions:

• FRED and PED demonstrate comparable efficacy in treating intracranial aneurysms.
• FRED is associated with better functional outcomes (mRS scores).
• PED presents higher risks of hemorrhage and re-treatment, necessitating careful consideration of safety profiles.