Comparison of Pipeline Embolization Device and Flow Re-Direction Endoluminal Device Flow Diverters for Internal Carotid Artery Aneurysms
Standard
Comparison of Pipeline Embolization Device and Flow Re-Direction Endoluminal Device Flow Diverters for Internal Carotid Artery Aneurysms : A Propensity Score-Matched Cohort Study. / Griessenauer, Christoph J; Thomas, Ajith J; Enriquez-Marulanda, Alejandro; Deshmukh, Aviraj; Jain, Abhi; Ogilvy, Christopher S; Kocer, Naci; Engelhorn, Tobias; Möhlenbruch, Markus; Holtmannspötter, Markus; Janssen, Hendrik; Finkenzeller, Thomas; Reith, Wolfgang; Sonnberger, Michael; Buhk, Jan-Hendrik; Schirmer, Clemens M; Killer-Oberpfalzer, Monika.
In: NEUROSURGERY, Vol. 85, No. 2, 01.08.2019, p. E249-E255.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Comparison of Pipeline Embolization Device and Flow Re-Direction Endoluminal Device Flow Diverters for Internal Carotid Artery Aneurysms
T2 - A Propensity Score-Matched Cohort Study
AU - Griessenauer, Christoph J
AU - Thomas, Ajith J
AU - Enriquez-Marulanda, Alejandro
AU - Deshmukh, Aviraj
AU - Jain, Abhi
AU - Ogilvy, Christopher S
AU - Kocer, Naci
AU - Engelhorn, Tobias
AU - Möhlenbruch, Markus
AU - Holtmannspötter, Markus
AU - Janssen, Hendrik
AU - Finkenzeller, Thomas
AU - Reith, Wolfgang
AU - Sonnberger, Michael
AU - Buhk, Jan-Hendrik
AU - Schirmer, Clemens M
AU - Killer-Oberpfalzer, Monika
N1 - Copyright © 2018 by the Congress of Neurological Surgeons.
PY - 2019/8/1
Y1 - 2019/8/1
N2 - BACKGROUND: Flow diversion has become an accepted endovascular treatment modality for intracranial aneurysms. Studies comparing different types of flow diverters are currently lacking.OBJECTIVE: To perform a propensity score-matched cohort study comparing the Pipeline Embolization Device (PED; Medtronic, Dublin, Ireland) and Flow Redirection Endoluminal Device (FRED; MicroVention, Aliso Viejo, California).METHODS: Aneurysms of the internal carotid artery proximal to the communicating segment treated with PED at 2 neurovascular centers in the United States were matched with aneurysms treated in the European FRED study using propensity scoring. Aneurysms treated in the setting of subarachnoid hemorrhage were excluded from matching. Occlusion rates and complications were evaluated.RESULTS: Two hundred twenty-one internal carotid artery aneurysms were treated with PED and 282 with FRED. Propensity score matching controlling for age, sex, aneurysm size, location, number of flow diverters, and adjunctive coiling resulted in 55 matched pairs. Median angiographic follow-up was nonsignificantly longer for FRED compared to PED (12.2 vs 7.5 mo, P = .28). The rate of complete occlusion did not differ between flow diverters (80% vs 80%, P > .99). Functional outcome and complications were comparable for PED and FRED.CONCLUSION: Propensity score-matched analysis of PED and FRED for internal carotid artery aneurysms revealed comparable angiographic complete occlusion and complication rates. Whether FRED has an advantage in terms of near complete aneurysm occlusion warrants further investigation. Limitations include the retrospective design and lack of an independent assessment of radiographic outcome in a core-laboratory and functional outcomes, among others, and the results should be interpreted as such.
AB - BACKGROUND: Flow diversion has become an accepted endovascular treatment modality for intracranial aneurysms. Studies comparing different types of flow diverters are currently lacking.OBJECTIVE: To perform a propensity score-matched cohort study comparing the Pipeline Embolization Device (PED; Medtronic, Dublin, Ireland) and Flow Redirection Endoluminal Device (FRED; MicroVention, Aliso Viejo, California).METHODS: Aneurysms of the internal carotid artery proximal to the communicating segment treated with PED at 2 neurovascular centers in the United States were matched with aneurysms treated in the European FRED study using propensity scoring. Aneurysms treated in the setting of subarachnoid hemorrhage were excluded from matching. Occlusion rates and complications were evaluated.RESULTS: Two hundred twenty-one internal carotid artery aneurysms were treated with PED and 282 with FRED. Propensity score matching controlling for age, sex, aneurysm size, location, number of flow diverters, and adjunctive coiling resulted in 55 matched pairs. Median angiographic follow-up was nonsignificantly longer for FRED compared to PED (12.2 vs 7.5 mo, P = .28). The rate of complete occlusion did not differ between flow diverters (80% vs 80%, P > .99). Functional outcome and complications were comparable for PED and FRED.CONCLUSION: Propensity score-matched analysis of PED and FRED for internal carotid artery aneurysms revealed comparable angiographic complete occlusion and complication rates. Whether FRED has an advantage in terms of near complete aneurysm occlusion warrants further investigation. Limitations include the retrospective design and lack of an independent assessment of radiographic outcome in a core-laboratory and functional outcomes, among others, and the results should be interpreted as such.
KW - Journal Article
KW - Humans
KW - Middle Aged
KW - Embolization, Therapeutic/instrumentation
KW - Carotid Artery Diseases/therapy
KW - Male
KW - Blood Vessel Prosthesis
KW - Carotid Artery, Internal
KW - Endovascular Procedures/methods
KW - Propensity Score
KW - Adult
KW - Female
KW - Aged
KW - Retrospective Studies
KW - Intracranial Aneurysm/therapy
KW - Cohort Studies
U2 - 10.1093/neuros/nyy572
DO - 10.1093/neuros/nyy572
M3 - SCORING: Journal article
C2 - 30541114
VL - 85
SP - E249-E255
JO - NEUROSURGERY
JF - NEUROSURGERY
SN - 0148-396X
IS - 2
ER -
