Small flow-redirecting endoluminal devices, also known as FREDs, are the next major advance in the treatment of aneurysms.
FRED, short for endoluminal flow redirecting device, is a two-layer nickel-titanium wire mesh tube designed to direct blood flow through a brain aneurysm.
A brain aneurysm occurs when a weakened part of an artery wall swells, forming a blood-filled bulge. Left untreated, a leaking or ruptured aneurysm is like a time bomb that can lead to stroke, brain damage, coma, and death.
Typically, surgeons treat aneurysms with a procedure called an endovascular coil. Surgeons insert a microcatheter through a small incision in the femoral artery in the groin, pass it to the brain, and coil the sac of the aneurysm, preventing blood from flowing into the aneurysm. The method works well for small aneurysms, 10 mm or less, but not for larger aneurysms.
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“When we put a coil in a small aneurysm, it works great,” said Orlando Diaz, MD, an interventional neuroradiologist at Houston Methodist Hospital, where he led the FRED clinical trial, which included more patients than any other hospital. hospital in the USA. USA. “But the coil can condense into a large, giant aneurysm. It can restart and kill the patient.”
The FRED system, developed by medical device company MicroVention, redirects blood flow at the site of an aneurysm. Surgeons insert the device through a microcatheter and place it at the base of the aneurysm without directly touching the aneurysmal sac. As the device is pushed out of the catheter, it expands to form a coiled mesh tube.
Instead of occluding the aneurysm, FRED immediately stopped the blood flow in the aneurysmal sac by 35%.
“This changes hemodynamics, which causes the aneurysm to dry out,” Diaz said. “After six months, it eventually withers and dies on its own. Ninety percent of the aneurysms are gone.”
Over time, the tissue around the device grows and occludes the aneurysm, effectively forming a new repaired blood vessel.