What are the occlusion rates of cerebral aneurysms treated with the Flow Re-direction Endoluminal Device (FredX)?

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Last updated: February 24, 2025 • View editorial policy

From the Guidelines

Occlusion rates for brain aneurysms treated with the Flow Re-direction Endoluminal Device (FredX) are generally high, ranging from 70% to 90% within 6 to 12 months after treatment, as reported in recent studies 1, 2, 3, 4. The occlusion process is gradual, with the flow diverter redirecting blood flow away from the aneurysm, promoting thrombosis and eventual closure. Factors affecting occlusion rates include aneurysm size, location, and morphology. Larger aneurysms or those with complex shapes may have lower occlusion rates.

  • Immediate complete occlusion is less common, often occurring in only 20-30% of cases initially.
  • Patients usually require follow-up imaging at 3-6 months and again at 12 months to assess occlusion status.
  • Antiplatelet therapy is typically required for several months post-procedure to prevent device thrombosis, which can impact the occlusion process.
  • Even if complete occlusion is not achieved, significant reduction in aneurysm size and risk of rupture is often observed, as noted in studies such as the Analysis of Treatment by Endovascular Approach of Non-ruptured Aneurysms (ATENA) 1. It's essential to consider the risk of treatment, patient age, presence of medical comorbidities, and aneurysm location and size when deciding on the treatment approach, as these factors can significantly impact perioperative morbidity and rupture risk 4.

From the Research

Occlusion Rates of Cerebral Aneurysms Treated with the Flow Re-direction Endoluminal Device (FredX)

  • The FREDX device has shown improved complete occlusion rates at 1 year compared to the FRED device, with a rate of 79.4% vs 59.3% 5.
  • A study on the FREDX device reported a complete occlusion rate of 66.0% after a mean follow-up of 7.0 months 6.
  • In comparison, the FRED device has shown complete occlusion rates ranging from 32% to 100% at different follow-up time points 7.
  • Another study on the FRED device reported complete occlusion rates of 58.1% at 3-month follow-up and 75.0% at 12-month follow-up 8.
  • The FRED flow diverter has also shown high occlusion rates at 3 and 6 months, with rates of 72.3% and 87.2%, respectively 9.

Comparison of Occlusion Rates between FRED and FREDX Devices

  • The FREDX device has shown a 3.04-fold increased likelihood of achieving complete occlusion at 1 year compared to the FRED device 5.
  • The FREDX device has also shown a trend towards fewer complications compared to the FRED device, with a median reduction of 5.5% in the posterior distribution of the prevalence of complications 5.

Safety Profile of the FREDX Device

  • The FREDX device has shown a low rate of major adverse events, with a rate of 3.1% 6.
  • The device has also shown a low rate of thrombotic events, with a rate of 4.3% 6.
  • The rate of postinterventional neurologic morbidity and mortality was observed to be 1.9% and 1.2%, respectively 6.

References

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.