Intracranial Aneurysms: Midterm Outcome of Pipeline Embolization Device—A Prospective Study in 143 Patients with 178 Aneurysms

Yu, Simon Chun‐Ho; Kwok, Ching-Kwong; Cheng, Ping; Chan, Kwong‐Yau; Lau, Sien-Ting; Lui, WM; Leung, K F; Lee, Raymand; Cheng, Harold Kin-Ming; Cheung, Y L; Chan, C. M.; Wong, George Kwok-Chu; Hui, J.Y.; Wong, Yiu-Chung; Tan, Chong-Boon; Poon, Wai Lun; Pang, K.Y.; Wong, Alice Yuen Kwan; Fung, Kai-hung

doi:10.1148/radiol.12120422

Cited by 198 publications

(150 citation statements)

References 18 publications

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“…In most series, remarkably high rates of aneurysm occlusion were achieved at follow-up with an acceptable risk for major complications. [1][2][3][4][5] Some authors, based on favorable results from noncontrolled series, have even recommended the PED as a first-line option for unruptured aneurysms. 3 Long-term safety results, however, are lacking and new complications have been emerging as neurointerventionalists accumulate experience with the device.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Delayed Migration/Shortening of the Pipeline Embolization Device: Report of 5 Cases

Chalouhi

Tjoumakaris

Gonzalez

et al. 2013

AJNR Am J Neuroradiol

104

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SUMMARY: Five patients were found to have spontaneous delayed migration/shortening of their Pipeline Embolization Devices on follow-up angiography. The device migrated proximally in 4 patients and distally in 1 patient. One patient had a subarachnoid hemorrhage and died as a result of migration of the Pipeline Embolization Device, and another patient presented with complete MCA occlusion and was left severely disabled. Mismatch in arterial diameter between inflow and outflow vessels was a constant finding. Migration of the Pipeline Embolization Device was managed conservatively, with additional placement of the device, or with parent vessel occlusion. Obtaining complete expansion of the embolization device by using a longer device, increasing vessel coverage, using adjunctive aneurysm coiling, and avoiding dragging and stretching of the device are important preventive measures. Neurointerventionalists should be aware of this potentially fatal complication and take all necessary preventive measures. ABBREVIATIONS:PED ϭ Pipeline Embolization Device; SHA ϭ superior hypophyseal artery

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Section: Discussionmentioning

confidence: 99%

Spontaneous Delayed Migration/Shortening of the Pipeline Embolization Device: Report of 5 Cases

Chalouhi

Tjoumakaris

Gonzalez

et al. 2013

AJNR Am J Neuroradiol

104

View full text Add to dashboard Cite

show abstract

“…In addition, many studies have reported higher occlusion rates among CCA subgroups. 6,27 This extra success afforded to the cavernous segment is likely multifold. Even though this carotid segment is usually tortuous, there were no major bifurcations occurring on it, which resulted in lower wall sheer stress on the vessel wall and less blood flow through the stent.…”

Section: Flow Diversion For Ccasmentioning

confidence: 99%

Cavernous Carotid Aneurysms in the Era of Flow Diversion: A Need to Revisit Treatment Paradigms

Tanweer¹,

Raz²,

Brunswick³

et al. 2014

AJNR Am J Neuroradiol

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“…A study on 251 aneurysms treated with PED demonstrated permanent morbidity and mortality of only 1% and 0.5%, respectively (15). Yu et al reported a complete aneurysm occlusion rate of 84% in a multicenter study with peri-procedural death or stroke seen in 3.5% (16). They suggested PED to be the first line choice for treating un-ruptured intracranial aneurysms.…”

Section: Discussionmentioning

confidence: 99%

Mid-Term Outcome Following Pipeline Embolization of Unruptured Intracranial Aneurysms

et al. 2017

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Background: As an advanced generation of flow diverters (FD), pipeline embolization device (PED) is introduced for endovascular aneurysm occlusion. In the present study, we aimed to present the mid-term results after endovascular treatment of unruptured intracranial aneurysms using PED. Methods: A total of 20 patients with 20 intracranial wide neck aneurysms were treated with PED between July and October 2010. Patients were followed up 4 to 8 months after the procedure. Digital subtraction angiography (DSA) was carried out to assess stent integrity, displacement, and the presence of residual aneurysm. Results: Out of 20 participants, PED deployment was successful in 19; whereas, intervention failed in one patient due to technical factors in device deployment. No severe acute complications were observed. One patient died after three months as a result of subarachnoid hemorrhage (SAH). Out of the remaining patients, DSA showed complete occlusion of aneurysms in 14 individuals (77.8%), while in four patients (22.2%), residual aneurysm was noted. Stent migration was not observed in any patients. Intra-stent stenosis (25% -50%) was visualized in only one patient (5.5%). Conclusions: This study showed promising mid-term results for the pipeline embolization device in the treatment of unruptured intracranial aneurysms. Larger studies with longer follow-up duration are warranted.

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Intracranial Aneurysms: Midterm Outcome of Pipeline Embolization Device—A Prospective Study in 143 Patients with 178 Aneurysms

Abstract: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12120422/-/DC1.

Cited by 198 publications

References 18 publications

Spontaneous Delayed Migration/Shortening of the Pipeline Embolization Device: Report of 5 Cases

Spontaneous Delayed Migration/Shortening of the Pipeline Embolization Device: Report of 5 Cases

Cavernous Carotid Aneurysms in the Era of Flow Diversion: A Need to Revisit Treatment Paradigms

Mid-Term Outcome Following Pipeline Embolization of Unruptured Intracranial Aneurysms

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