New type of stents could help brains

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A new generation of stents – but not for the heart. This device travels to vessels in the brain where large aneurysms loom.
Dr. Bernard Bendok, Northwestern Medicine Neurosurgeon: “Very large aneurysm right there.”

It’s tough to miss. Classified as a wide-neck aneurysm -- the giant, balloon-like bulge in Sue Wakulich’s brain vessel left her with double vision and regular headaches.

Sue Wakulich, aneurysm patient: “Right away panic sets in because you don’t want your head cut open.”

Northwestern Medicine neurosurgeon Dr. Bernard Bendok quickly put Sue’s fears to rest. He had another plan.

Dr. Bendok: “This would have been science fiction 10 years ago.”

This is FRED – or a flow redirection endoluminal device. The system – a catheter and a nitinol mesh stent -- was designed to treat wide neck cerebral aneurysms. Smaller lesions can be clipped off or filled with coils. But patients like Sue face riskier options.

Dr. Bendok: “The old treatment for this would have been to close the artery. If you can’t clip it, you can’t coil it, why don’t you just close the artery? Eighty percent of people can tolerate that. But 20 percent of people have a stroke. This technology was developed to tackle that 10 percent of aneurysms or 20 percent maybe that don’t have good solutions.”

The idea is to keep blood moving through the artery – blocking most of the fluid from entering the aneurysm, where it increases pressure on the already-weakened vessel wall and boosts the risk for rupture.

Dr. Bendok: “The first flow diverter came out maybe four years ago. This is new and improved, what I call a 2.0 version, a better improved version. This is the first clinical trial of this device.”

And Sue was the first to undergo the procedure at Northwestern Memorial Hospital.

Sue Wakulich: “The stent is so little and it implants in your head, it’s amazing.”

Just like cardiologists place a stent in the heart, neurosurgeons start in the groin, threading a catheter to a check point in the neck.

Dr. Bendok: “Then you see a smaller catheter we take up beyond the aneurysm. You watch it deploy, give it a minute, because this metal, as it heats up expands, it takes its shape, hugs the wall.”

The stent is flexible like a Slinky, with a reinforced center.

Dr. Bendok: “It’s denser in the middle because that’s the part that covers the aneurysm.”

Sue Wakulich: “I have a better peace of mind for having the stent in.”

Northwestern is just one site for the FRED clinical trial. So far 44 patients have been enrolled nationwide, and doctors hope to treat a total of 127. The goal is to determine the device’s safety and efficacy.
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