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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleNeurointervention

Treatment of Ruptured Blister-Like Aneurysms with the FRED Flow Diverter: A Multicenter Experience

M.A. Möhlenbruch, F. Seker, E. Özlük, O. Kizilkilic, E. Broussalis, M. Killer-Oberpfalzer, C.J. Griessenauer, M. Bendszus and N. Kocer
American Journal of Neuroradiology December 2020, 41 (12) 2280-2284; DOI: https://doi.org/10.3174/ajnr.A6849
M.A. Möhlenbruch
aFrom the Department of Neuroradiology (M.A.M., F.S., M.B.), Heidelberg University Hospital, Heidelberg, Germany
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  • ORCID record for M.A. Möhlenbruch
F. Seker
aFrom the Department of Neuroradiology (M.A.M., F.S., M.B.), Heidelberg University Hospital, Heidelberg, Germany
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E. Özlük
bDepartment of Radiology (E.Ö.), Acibadem University Atakent International Hospital, Istanbul, Turkey
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O. Kizilkilic
cDivision of Neuroradiology (O.K., N.K.), Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
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E. Broussalis
dResearch Institute of Neurointervention (E.B., M.K.-O., C.J.G.), Paracelsus Medical University, Salzburg, Austria
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M. Killer-Oberpfalzer
dResearch Institute of Neurointervention (E.B., M.K.-O., C.J.G.), Paracelsus Medical University, Salzburg, Austria
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C.J. Griessenauer
dResearch Institute of Neurointervention (E.B., M.K.-O., C.J.G.), Paracelsus Medical University, Salzburg, Austria
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M. Bendszus
aFrom the Department of Neuroradiology (M.A.M., F.S., M.B.), Heidelberg University Hospital, Heidelberg, Germany
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N. Kocer
cDivision of Neuroradiology (O.K., N.K.), Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
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    FIGURE.

    A, Nonenhanced head CT of a female patient in her 50s showing subarachnoid hemorrhage, Hunt and Hess grade 4, and Fisher grade 4. B, Angiography reveals a blister-like aneurysm of the right supraclinoid ICA with a maximum neck diameter of 3.3 mm. C, Angiographic result immediately after deployment of FRED 4.0 × 13 mm. D, Follow-up angiography at day 17 shows a residual aneurysm filling. E and F, Follow-up angiography at 3 months demonstrates complete aneurysm obliteration. mRS score at 3 months was 1.

Tables

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    Table 1:

    Baseline characteristics

    CharacteristicValue
    Age (mean) (SD) (yr)55.6 (12.9)
    Female (No.) (%)19 (63.3)
    Hunt and Hess grade (No.) (%)
     113 (43.3)
     24 (13.3)
     35 (16.7)
     46 (20.0)
     52 (6.7)
    Fisher grade (No.) (%)
     13 (10.0)
     214 (46.7)
     37 (23.3)
     46 (20.0)
    Extraventricular drain (No.) (%)
     Before aneurysm treatment14 (46.7)
     After aneurysm treatment0 (0)
     None16 (53.3)
    • View popup
    Table 2:

    Aneurysm characteristics

    CharacteristicsValue
    Aneurysm rupture to treatment (No.) (%)
     0–1 day13 (43.3)
     2–7 days8 (26.7)
     >7 days9 (30.0)
    Aneurysm location (No.) (%)
     Internal carotid artery19 (63.3)
     Basilar artery7 (23.3)
     Vertebral artery2 (6.7)
     Anterior communicating artery1 (3.3)
     Posterior cerebral artery1 (3.3)
    Median aneurysm height (No.) (mm)1.7
    Median aneurysm diameter (No.) (mm)2
    Median diameter of parent vessel proximally (No.) (mm)3.5
    Median diameter parent vessel distally (No.) (mm)3
    Median diameter of FRED (No.) (mm)4
    Median length of FRED (No.) (mm)13
    Median No. of FREDs used1
    Aneurysms that were additionally coiled (No.) (%)2 (6.7)
    • View popup
    Table 3:

    Aneurysm occlusion

    Occlusion GradingEnd of the Procedure (n = 30)At 6 Months (n = 26)At 12 Months (n = 26)Last Follow-Upa (n = 26)
    OKM (No.) (%)
     D10 (33.3)21 (80.8)22 (84.6)24 (92.3)
     C4 (13.3)3 (11.5)3 (11.5)2 (7.7)
     B16 (53.3)2 (7.7)1 (3.8)0 (0)
     A0 (0)0 (0)0 (0)0 (0)
    • ↵a Median last follow-up was approximately 22 months (interquartile range, 12–37 months).

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American Journal of Neuroradiology: 41 (12)
American Journal of Neuroradiology
Vol. 41, Issue 12
1 Dec 2020
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M.A. Möhlenbruch, F. Seker, E. Özlük, O. Kizilkilic, E. Broussalis, M. Killer-Oberpfalzer, C.J. Griessenauer, M. Bendszus, N. Kocer
Treatment of Ruptured Blister-Like Aneurysms with the FRED Flow Diverter: A Multicenter Experience
American Journal of Neuroradiology Dec 2020, 41 (12) 2280-2284; DOI: 10.3174/ajnr.A6849

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Treatment of Ruptured Blister-Like Aneurysms with the FRED Flow Diverter: A Multicenter Experience
M.A. Möhlenbruch, F. Seker, E. Özlük, O. Kizilkilic, E. Broussalis, M. Killer-Oberpfalzer, C.J. Griessenauer, M. Bendszus, N. Kocer
American Journal of Neuroradiology Dec 2020, 41 (12) 2280-2284; DOI: 10.3174/ajnr.A6849
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