1382 Comparative Analysis of Safety and Efficacy of Flow Diversion With and Without Surface Modification Technology, FRED-X, FRED, PED Shield and PED In 386 Patients

INTRODUCTION: The FRED-X is a newer generation flow diverting stent (FDS) with surface modification that has demonstrated favorable safety profile and efficacy in treating intracranial aneurysms. To our knowledge, its efficacy has not been evaluated with regard to other available FDS with or without surface modification tehcnlogy. METHODS: This was a retrospective study of a prospectively maintained database from a single institution. All patients who underwent flow diversion for treatment of an intracranial aneurysm using FRED-X, FRED, PED or PED Shield were included. Descriptive statistics and univariate analyses were calculated for all cohorts. Multivariate logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CI) for long-term outcomes of interest- angiographic occlusion, in-stent stenosis and functional outcome at 6- and 12-month follow up. RESULTS: 386 patients with 386 aneurysms were included. The average age of the cohort was 56.2 years, and 81% was female. The PED cohort had the highest rate of mortality. PED had significantly higher aneurysm occlusion rates compared to FRED-X at 6- and 12-months (OR: 3.03, 95% CI: 1.36- 6.62 and OR: 4.01, 95% CI: 1.26- 12.2), with higher odds of absent in-stent stenosis (OR: 9.03, 95% CI: 3.63- 23.3 and OR: 9.58, 95% CI: 2.56- 33.8) at 6- and 12-months, respectively. Rates of stroke, TIA, ICH and mortality were not significantly different across cohorts. All patients were functionally independent on follow-up. CONCLUSIONS: Our study revealed comparable occlusion rates and in-stent stenosis between surface modified devices- FRED-X and PED Shield. Angiographic occlusion rates were comparable between FRED-X and the first generation FRED. The classic PED demonstrated higher aneurysmal occlusion rates compared to FRED-X.