Comparison of pipeline embolization device and flow redirection endoluminal device in the treatment of intracranial aneurysms: A systematic review and meta-analysis.

Authors

• Basel Musmar
• Atakan Orscelik
• Hamza Salim
• Fares Musmar
• Nimer Adeeb
• Kareem El Naamani
• Muhammed Amir Essibayi
• Samantha Spellicy
• Jihad Abdelgadir
• Adam A Dmytriw
• Aman B Patel
• Vitor Mendes Pereira
• Hugo H Cuellar-Saenz
• Bharat Guthikonda
• Ali Zomorodi
• Pascal Jabbour
• David Hasan

Publication/Presentation Date

8-1-2026

Abstract

BackgroundAdvancements in flow diversion technology have revolutionized the treatment of intracranial aneurysms. The pipeline embolization device (PED) and the flow redirection endoluminal device (FRED) have emerged as prominent tools in this field. This study aims to compare the safety and efficacy profiles of PED and FRED in the treatment of intracranial aneurysms.MethodsFollowing the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive literature search was conducted across PubMed, Web of Science, and Scopus databases. Studies comparing PED and FRED were included and data extraction focused on study characteristics, patient demographics, and clinical and radiological outcomes. Primary outcomes were favorable outcomes, described as modified Rankin scale (mRS) 0-2 score, and complete/near-complete occlusion, while secondary outcomes included retreatment rate and thromboembolic and hemorrhagic complications.ResultsFive studies, comprising 1238 patients, were included. No significant differences were found between PED and FRED in terms of complete occlusion at 6 months and 1 year, complete/near-complete occlusion at the last follow up, retreatment rates, and thromboembolic, in-stent thrombosis and hemorrhagic complications. However, FRED was significantly associated with higher favorable outcomes compared to PED (odds ratio: 0.37; confidence interval: 0.17 to 0.81; p = 0.01).ConclusionThis study showed that both PED and FRED had comparable rates of complete occlusion, retreatment and complications, and FRED also demonstrated a higher likelihood of achieving favorable outcomes. The study underscores the need for further research with larger cohorts and longer follow up to consolidate these findings.

Volume

32

Issue

4

First Page

1691

Last Page

1699

ISSN

2385-2011

Published In/Presented At

Musmar, B., Orscelik, A., Salim, H., Musmar, F., Adeeb, N., Naamani, K. E., Essibayi, M. A., Spellicy, S., Abdelgadir, J., Dmytriw, A. A., Patel, A. B., Pereira, V. M., Cuellar-Saenz, H. H., Guthikonda, B., Zomorodi, A., Jabbour, P., & Hasan, D. (2026). Comparison of pipeline embolization device and flow redirection endoluminal device in the treatment of intracranial aneurysms: A systematic review and meta-analysis. Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences, 32(4), 1691–1699. https://doi.org/10.1177/15910199241264345

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

39053432

Department(s)

Administration and Leadership

Document Type

Article