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. 2024 Jan 12;18(3):59–64. doi: 10.5797/jnet.ra.2023-0078

Table 1. Flow diverters available in Japan.

FDs Approved year Indications Structure Material Surface material
Pipeline Flex with Shield technology* 2015

  • ICA (petrous to supraclinoid), VA

  • Aneurysm size ≥5 mm

  • Length of neck ≥4 mm or D/N ratio <2

 Mono layer (48 wires) Cobalt/chromium (36 wires)
Platinum/tungsten (12 wires)		 MPC polymer
FRED** 2019 ICA, proximal ACA, proximal MCA, VA, BA

  • Aneurysm size ≥5 mm

  • Length of neck ≥4 mm or D/N ratio <2

 Dual layer (66 wires) Nitinol (64 wires)
Tantalum (2 wires)		 Bare metal
Surpass Streamline*** 2021 ICA (petrous to supraclinoid)

  • Aneurysm size ≥10 mm

  • Length of neck ≥4 mm or D/N ratio <2

 Mono layer (72 or 96 wires) Cobalt/chromium Platinum/tungsten Bare metal

*Medtronic, **Terumo MicroVention, and *** Stryker.

ACA: anterior cerebral artery; BA: Basilar artery; D/N ratio: dome-to-neck ratio; ICA: internal carotid artery; MCA: middle cerebral artery; MPC: methacryloyloxyethyl phosphorylcholine; VA: vertebral artery