Pipeline-assisted coiling versus pipeline in flow diversion treatment of intracranial aneurysms

Sweid, Ahmad; Atallah, Elias; Herial, Nabeel A.; Saad, Hassan; Mouchtouris, Nikolaos; Barros, Guilherme; Gooch, M. Reid; Tjoumakaris, Stavropoula; Zarzour, Hekmat; Hasan, David; Chalouhi, Nohra; Rosenwasser, Robert H.; Jabbour, Pascal

doi:10.1016/j.jocn.2018.10.081

Cited by 26 publications

(17 citation statements)

References 19 publications

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“…Second, the putative occlusion rate differences are unlikely to be caused by a difference in adjunctive coiling as the PITA study adjunctive coil rate was higher (51.6%) whilst the PUFS rate was lower (0.9%) compared to our rate (28.8%). A lack of relationship between occlusion rates and adjunctive coil rates might be expected as there is little evidence that adjunctive coiling when using flow-diverter devices is beneficial 29 . Anecdotally there is more motivation for adjunctive coiling to prevent rupture of large aneurysms during thrombosis rather than to influence occlusion rates.…”

Section: Discussionmentioning

confidence: 99%

Outcome Study of the Pipeline Embolization Device with Shield Technology in Unruptured Aneurysms (PEDSU)

Atasoy

Kandasamy²,

Hart³

et al. 2019

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: The recently introduced Pipeline Flex Embolization Device with Shield Technology (Pipeline Shield) is the third generation of Pipeline flow-diverter devices. It has a new stent-surface modification, which reduces thrombogenicity. We aimed to evaluate clinical and radiographic (safety and efficacy) outcomes of the Pipeline Shield. MATERIALS AND METHODS: The 30-day and 1-year mortality and morbidity rates and the 6-and 18-month radiographic aneurysm occlusion outcomesIndicates open access to non-subscribers at www.ajnr.org http://dx.

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Section: Discussionmentioning

confidence: 99%

Outcome Study of the Pipeline Embolization Device with Shield Technology in Unruptured Aneurysms (PEDSU)

Atasoy

Kandasamy²,

Hart³

et al. 2019

AJNR Am J Neuroradiol

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“…Retreatment rates among both FDAC and SAC have been shown to be significantly lower than coil embolization alone, with equivocal safety profiles in complex lesions. [ 5 41 42 ] Likely owing to the added benefit of diversion of laminar flow secondary to increased coverage, FDAC has also been reported to have significantly lower retreatment rates as compared to SAC. [ 5 41 42 ] Furthermore, FDAC has shown to be more cost-effective as compared to SAC, likely owing to the decreased number of coils required in dual-modality treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Flow diversion (FD) technology, initially introduced for the management of large unruptured aneurysms of the petrous to communicating segments of the internal carotid artery (ICA), has been increasingly and successfully applied to off-label indications. [ 4 5 6 ] In the United States, the primary experience has been with the pipeline embolization device (PED), however, a number of additional devices have now begun to enter the market. [ 4 ] Flow-diverting stents rely on increased metal coverage to restrict flow into the aneurysm, promote thrombosis, and provide a scaffold for endothelialization across the neck.…”

Section: Introductionmentioning

confidence: 99%

Vertebral artery dissection and associated ruptured intracranial pseudoaneurysm successfully treated with coil assisted flow diversion: A case report and review of the literature

et al. 2021

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“…In addition, the coils may also protect against delayed aneurysm rupture as stasis promoters and result in higher rates of IFCA occlusion (50,51). However, the effect of coiling assistance in FD deployment remains controversial in chronic IFCAs, and coiling does not prompt aneurysm occlusion (52).…”

Section: Fd Deploymentmentioning

confidence: 99%

Intracranial Fusiform and Circumferential Aneurysms of the Main Trunk: Therapeutic Dilemmas and Prospects

et al. 2021

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Intracranial fusiform and circumferential aneurysms (IFCAs), especially those located on the main trunk, are uncommon and difficult to manage. Currently, literature focused on IFCAs on the main trunk of cerebral arteries is lacking. The treatment of IFCAs is still under debate. Therefore, in this review, we further explore the treatment of this complicated entity. In addition, we also present some interesting cases. Based on the literature review and our experience, we found that IFCAs are often located in the vertebrobasilar system and that ruptured or large symptomatic IFCAs are associated with increased mortality and higher rebleeding rates. The treatment strategies for IFCAs can be classified as deconstructive and reconstructive methods via open surgery and/or endovascular treatment (EVT). Currently, EVT is a popular method and the main therapeutic choice. In particular, flow diversion has revolutionized the treatment of IFCAs. Parent artery occlusion (PAO) with or without revascularization may still be considered a suitable choice. Complex IFCAs that cannot be resolved by EVT can also be treated via open surgery with or without extracranial–intracranial bypass. Targeted embolization for the weak points of IFCAs is a temporary or palliative choice that is rarely used. In summary, despite complications, both surgical treatment and EVT are effective options for appropriately selected cases. Due to the development of endovascular implants, EVT will have better prospects in the future.

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Pipeline-assisted coiling versus pipeline in flow diversion treatment of intracranial aneurysms

Cited by 26 publications

References 19 publications

Outcome Study of the Pipeline Embolization Device with Shield Technology in Unruptured Aneurysms (PEDSU)

Outcome Study of the Pipeline Embolization Device with Shield Technology in Unruptured Aneurysms (PEDSU)

Vertebral artery dissection and associated ruptured intracranial pseudoaneurysm successfully treated with coil assisted flow diversion: A case report and review of the literature

Intracranial Fusiform and Circumferential Aneurysms of the Main Trunk: Therapeutic Dilemmas and Prospects

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