Patency of Branches after Coverage with Multiple Telescoping Flow-Diverter Devices: An In Vivo Study in Rabbits

Dai, Daying; Ding, Yong Hong; Kadirvel, R; Rad, Arash Ehteshami; Lewis, Daniel C.; Kallmes, David F.

doi:10.3174/ajnr.a2879

Cited by 44 publications

(25 citation statements)

References 14 publications

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“…Animal studies indicate a minimal but increased incidence of branch occlusion with lower stent porosity, 20 such as what might be found after FDS implantation across the PICA ostium and with multiple overlapping stents. 21 However, our study and others did not find an association between the number of devices and branch occlusion. Animal studies indicate that the perfusion demand of tissue supplied by branch vessels that are covered by the FDS maintains branch vessel patency.…”

Section: Discussioncontrasting

confidence: 47%

Posterior Inferior Cerebellar Artery Patency after Flow-Diverting Stent Treatment

Levitt

Park

Albuquerque

et al. 2015

AJNR Am J Neuroradiol

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Section: Discussioncontrasting

confidence: 47%

Posterior Inferior Cerebellar Artery Patency after Flow-Diverting Stent Treatment

Levitt

Park

Albuquerque

et al. 2015

AJNR Am J Neuroradiol

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“…10,30 Importantly, small branching feeders off the parent artery appear to remain intact even when covered by telescoping flow diverters, making these diverters especially useful when treating tandem aneurysms separated by a longer distance. 4,11,14,26,30 We successfully deployed 25 PEDs to treat 38 tandem aneurysms in 17 patients. The average Raymond score at the last follow-up was 1.3, and 89% of treated aneurysms had complete occlusion at the last follow-up.…”

Section: Discussionmentioning

confidence: 99%

Flow diversion of tandem cerebral aneurysms: a multi-institutional retrospective study

Awad

Moon

Yoon

et al. 2017

Neurosurgical Focus

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OBJECTIVEFlow diversion has proven to be an efficacious means of treating cerebral aneurysms that are refractory to other therapeutic means. Patients with tandem aneurysms treated with flow diversion have been included in larger, previously reported series; however, there are no dedicated reports on using this technique during a single session to treat this unique subset of patients. Therefore, the authors analyzed the outcomes of patients who had undergone single-session flow diversion for the treatment of tandem aneurysms.METHODSThe authors conducted a retrospective review of flow diversion with the Pipeline embolization device (PED) for the treatment of tandem aneurysms in a single session at 2 participating medical centers: University of Utah, Salt Lake City, Utah, and Barrow Neurological Institute, Phoenix, Arizona. Patient demographic data, aneurysm characteristics, treatment strategy and results, complications, and follow-up data were collected from the medical record and analyzed.RESULTSBetween January 2011 and December 2015, 17 patients (12 female, 5 male) with a total of 38 aneurysms (mean size 4.7 ± 2.7 mm, mean ± SD) were treated. Sixteen patients had aneurysms in the anterior circulation, and 1 patient had tandem aneurysms in the posterior circulation. Twelve patients underwent only placement of a PED, whereas 5 underwent adjunctive coil embolization of at least 1 aneurysm. One PED was used in each of 9 patients, and 2 PEDs were required in each of 8 patients. There were 2 intraprocedural complications; however, in both instances, the patients were asymptomatic at the last follow-up. The follow-up imaging studies were available for 15 patients at a mean of 7 months after treatment (216 days, range 0–540 days). The mean initial Raymond score after treatment was 2.7 ± 0.7, and the mean final score was 1.3 ± 0.7.CONCLUSIONSIn this series, the use of flow diversion for the treatment of tandem cerebral aneurysms had an acceptable safety profile, indicating that it should be considered as an effective therapy for this complicated subset of patients. Further prospective studies must be performed before more definitive conclusions can be made.

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“…In the literature, narrowing of collateral branches is rarely reported. Preclinical studies 9,[22][23][24][25][26] reported that flow within collateral arteries was maintained after the placement of a flow diverter. However, these arteries were considered end vessels without distal collaterals.…”

Section: Side Branches and Perforators Covered By The Pedmentioning

confidence: 99%

Extra-Aneurysmal Flow Modification Following Pipeline Embolization Device Implantation: Focus on Regional Branches, Perforators, and the Parent Vessel

Gascou

Lobotesis

Brunel³

et al. 2014

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Flow-diverter technology has proved to be a safe and effective treatment for intracranial aneurysm based on the concept of flow diversion allowing parent artery and collateral preservation and aneurysm healing. We investigated the patency of covered side branches and flow modification within the parent artery following placement of the Pipeline Embolization Device in the treatment of intracranial aneurysms.

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Patency of Branches after Coverage with Multiple Telescoping Flow-Diverter Devices: An In Vivo Study in Rabbits

Cited by 44 publications

References 14 publications

Posterior Inferior Cerebellar Artery Patency after Flow-Diverting Stent Treatment

Posterior Inferior Cerebellar Artery Patency after Flow-Diverting Stent Treatment

Flow diversion of tandem cerebral aneurysms: a multi-institutional retrospective study

Extra-Aneurysmal Flow Modification Following Pipeline Embolization Device Implantation: Focus on Regional Branches, Perforators, and the Parent Vessel

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