Background Endovascular treatment of intracranial aneurysms via flow diversion has become increasingly popular over the past several years. The flow redirection endoluminal device (FRED; Microvention, Tustin, California, USA) system is a next generation closed cell paired stent flow diversion device.

Objective Our initial clinical experience with the FRED system is described. We believe this series to be the first use of the FRED system in the western hemisphere.

Methods 14 aneurysms were treated utilizing the FRED system in 13 patients. Post-deployment angiography and fluoro CTs were obtained in all cases.

Results Immediate post-treatment angiography demonstrated reduced flow into all aneurysms although no long term angiographic data are yet available. The device proved technically easy to deploy and recapture after partial deployment if needed. No complications, technical or otherwise, were encountered. Radiographic visibility and ability to maintain its internal cylindrical shape in tortuous arteries, as demonstrated by fluoro CT, was at least as good as the pipeline embolization device.

Conclusions The FRED system was technically easy to deploy with no procedural complications occurring in this first reported series of 14 aneurysms. The ability of the FRED system to be recaptured after partial deployment and to maintain its internal shape in tortuous vessels was demonstrated well. Long term clinical and angiographic follow-up along with prospective studies are now needed to ascertain the role of the FRED in intracranial aneurysm treatment.