In-Stent Stenosis After Pipeline Embolization Device in Intracranial Aneurysms: Incidence, Predictors, and Clinical Outcomes

Abstract

BACKGROUND:In-stent stenosis (ISS) is a delayed complication that can occur after pipeline embolization device use when treating intracranial aneurysms (IAs). OBJECTIVE: To assess the incidence, predictors, and outcomes of ISS. METHODS: This was a retrospective, multicenter, observational study. All patient data were collected from a PLUS registry study. We collected data from patients with IA who completed digital subtraction angiography at follow-up and divided patients into "non-ISS," "mild ISS," or "severe ISS" groups. Multivariate logistic regression analysis was conducted to determine predictors of ISS. RESULTS: A total of 1171 consecutive patients with 1322 IAs participated in this study. Angiographic follow-up was available for 662 patients with 728 IAs, and the mean followup time was 9 months. ISS was detected in 73 cases (10.03%), including 61 mild ISS cases and 12 severe ISS cases. Univariate and multivariable analysis demonstrated that current smoking history (mild ISS:

Could statin improve outcomes after pipeline embolization for intracranial aneurysms in a real-world setting?

“…Patients were selected from the PLUS study, 2,16,17 which was a postmarket multicenter registry study investigating the embolization of intracranial aneurysms with the PED in China. The study included 1171 patients with 1322 intracranial aneurysms receiving embolization using PED treatment from November 2014 to October 2019 across 14 centers in China.…”

Letter: In-Stent Stenosis After Pipeline Embolization Device in Intracranial Aneurysms: Incidence, Predictors, and Clinical Outcomes

“…From Incidence to Insight: While the study by Turhon et al 1 provides a valuable snapshot of the current incidence and predictors of ISS, it also must catalyze further exploration. Our quest for knowledge should not stop at incidence rates alone; instead, we must venture beyond the surface and embark on a journey to gain a comprehensive insight into the intricate dynamics of ISS.…”

“…One such area of interest is the utilization of flow diverters, specifically the pipeline embolization device (PED), in treating intracranial aneurysms. Recent research by Turhon et al 1 shed light on the incidence, predictors, and clinical outcomes of in-stent stenosis (ISS) after PED implantation. We commend the authors for their comprehensive study, providing valuable insights into this phenomenon.…”

“…Unraveling the Predictors: Turhon et al 1 identify the current smoking status and cerebral atherosclerosis as independent predictors of ISS. These factors undoubtedly contribute to the increased risk of ISS.…”

“…The study by Turhon et al 1 is a commendable contribution to the field, shedding light on the incidence, predictors, and clinical outcomes of ISS after PED placement. However, it beckons us to venture further, to explore the underlying mechanisms, refine our definitions, and optimize our treatment strategies.…”