Anterior Choroidal Artery Patency and Clinical Follow-Up after Coverage with the Pipeline Embolization Device

Abstract

BACKGROUND AND PURPOSE:Endoluminal reconstruction with the Pipeline Embolization Device is an effective treatment option for select intracranial aneurysms. However, concerns for the patency of eloquent branch arteries covered by the Pipeline Embolization Device have been raised. We aimed to examine the patency of the anterior choroidal artery and clinical sequelae after ICA aneurysm treatment.

Stepwise stent deployment technique for tandem intracranial aneurysms: a review of 21 cases

“…There have been few reports concerning tandem intracranial aneurysms, a particular configuration of multiple aneurysms in which two aneurysms are closely located [4,5]. Tandem aneurysms are treated using a stepwise stent deployment technique only when the distance from the proximal end of the proximal aneurysm to the distal end of the distal aneurysm was < 30 mm.…”

“…Endovascular therapy is an alternative method of managing such lesions, although the stent deployed for one aneurysm could hinder the treatment of the other when they are broad-based. Flow diverters are increasingly used to treat intracranial aneurysms and have reportedly been successfully applied in the treatment of tandem aneurysms [4,5]. However, the application of flow diverters has been limited mainly to unruptured anterior circulation aneurysms in those studies.…”

Posterior Inferior Cerebellar Artery Patency after Flow-Diverting Stent Treatment

“…10 Finally, 2 reports with a combined total of 43 anterior choroidal arteries spanned by at least 1 FDS in the treatment of carotid aneurysms documented 2 branch occlusions (4.7%) at follow-up, without clinical sequelae. 11,12 No study found a significant association between branch occlusion and the number of FDS devices placed across vessel ostia.…”

The Fate of Side Branches Covered by Flow Diverters–Results from 140 Patients

“…This phenomenon has not been described to our knowledge and attests to the fact that flow diverters can modify the intracranial cerebrovascular architecture. Although there is a collateral supply to the anterior choroidal artery via the medial and lateral posterior choroidal arteries it is possible that these vessels are unable to provide a significant enough collateral supply to enable endothelialsation across the ostium of the anterior choroidal artery however, in a single case of the study by Raz et al 36 retrograde reconstitution of the anterior choroidal after occlusion was reported as mentioned earlier. Additionally, at nominal diameter the PED pore size is between 0.02-0.05mm 2 13 .…”