Utilization of Pipeline embolization device for treatment of ruptured intracranial aneurysms: US multicenter experience

Lin, Ning; Brouillard, Adam M.; Keigher, Kiffon M; Lopes, Demetrius K.; Binning, Mandy J.; Liebman, Kenneth; Veznedaroglu, Erol; Magarik, Jordan A.; Mocco, J; Duckworth, Edward; Arthur, Adam S; Ringer, Andrew J.; Snyder, Kenneth V.; Levy, Elad I.; Siddiqui, Adnan H.

doi:10.1136/neurintsurg-2014-011320

Cited by 115 publications

(66 citation statements)

References 21 publications

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“…Considering this and the antiplatelet therapy, the risk of rehemorrhage would be theoretically higher with the PED. 45 However, in certain cases of complex ruptured aneurysms, the PED may still serve as a good alternative (and sometimes may be the only available option) because these aneurysms are anatomically and technically more difficult to treat using standard techniques.…”

Section: Ruptured Aneurysmsmentioning

confidence: 99%

“…When treating aneurysmal subarachnoid hemorrhages (SAHs), multiple additional intracranial procedures may be required, such as external ventricular drain placement, ventriculoperitoneal shunt insertion, or decompressive craniotomy for hematoma evacuation. 45 These subsequent surgeries can be complicated by the dual antiplatelet therapy that is required in conjunction with PED placement. In addition, placement of flow diverters like the PED results in gradual rather than immediate thrombosis of the aneurysm.…”

Section: Ruptured Aneurysmsmentioning

confidence: 99%

“…Lin and colleagues presented the largest series on PED treatment for ruptured aneurysms, looking at a total of 26 cases. 45 The periprocedural complication rate was 19.2% (5/26) and included 3 deaths. Complete occlusion was achieved in 78.3%, and a modified Rankin Scale (mRS) score of 0-2 was reported in 76.9%.…”

mentioning

confidence: 99%

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Off-label uses of the Pipeline embolization device: a review of the literature

Patel

Chalouhi

Atallah

et al. 2017

Neurosurgical Focus

141

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The Pipeline embolization device (PED) is the most widely used flow diverter in endovascular neurosurgery. In 2011, the device received FDA approval for the treatment of large and giant aneurysms in the internal carotid artery extending from the petrous to the superior hypophyseal segments. However, as popularity of the device grew and neurosurgeons gained more experience, its use has extended to several other indications. Some of these off-label uses include previously treated aneurysms, acutely ruptured aneurysms, small aneurysms, distal circulation aneurysms, posterior circulation aneurysms, fusiform aneurysms, dissecting aneurysms, pseudoaneurysms, and even carotid-cavernous fistulas. The authors present a literature review of the safety and efficacy of the PED in these off-label uses.

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Section: Ruptured Aneurysmsmentioning

confidence: 99%

Section: Ruptured Aneurysmsmentioning

confidence: 99%

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Off-label uses of the Pipeline embolization device: a review of the literature

Patel

Chalouhi

Atallah

et al. 2017

Neurosurgical Focus

141

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“…Small series are also arising looking at Pipeline embolization in ruptured aneurysms, however complication (19.2%) and cure rates (78.3%) remain unacceptable 84,85 . The role and duration of antiplatelets must also be addressed.…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 96%

Endoscopic Endonasal Clipping of Intracranial Aneurysms: Surgical Technique and Results

et al. 2015

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“…5) and Silk (Balt Extrusion) for treatment of blister aneurysms is gaining in popularity and has the potential for becoming the standard of care. 3,5,6,9,10,25,[30][31][32][33]39,49 In their 2017 study of 10 patients with ruptured blister pathology and an average Hunt and Hess score of 1.6 on presentation, Linfante et al noted successful deployment of the PED in 9 patients. 31 Eight of the 9 patients treated with the PED had a 90-day mRS score of 0, and the remaining patient had a score of 1.…”

Section: Flow Diversionmentioning

confidence: 99%

Endovascular treatment of blister aneurysms

Peitz¹,

Sy²,

Grandhi³

2017

Neurosurgical Focus

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Blister aneurysms are rare cerebrovascular lesions for which the treatment methods are reviewed here, with a focus on endovascular options. The reported pathogenesis of blister aneurysms varies, and hemodynamic stress, arterial dissection, and arteriosclerotic ulceration have all been described. There is consensus on the excessive fragility of blister aneurysms and their parent vessels, which makes clipping technically difficult. Open surgical treatment is associated with high rates of complications, morbidity, and mortality; endovascular treatment is a promising alternative. Among endovascular treatment options, deconstructive treatment has been associated with higher morbidity compared with reconstructive methods such as direct embolization, stent- or balloon-assisted direct embolization, stent monotherapy, and flow diversion. Flow diversion has been associated with higher technical success rates and similar clinical outcomes compared with non–flow diverting treatment methods. However, delayed aneurysm occlusion and the need for antiplatelet therapy are potential drawbacks to flow diversion that must be considered when choosing among treatment methods for blister aneurysms.

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Utilization of Pipeline embolization device for treatment of ruptured intracranial aneurysms: US multicenter experience

Abstract: The PED can be utilized for ruptured aneurysms and is a good option for blister-type aneurysms. However, due to periprocedural complications, it should be reserved for lesions that are difficult to treat by conventional clipping or coiling.

Cited by 115 publications

References 21 publications

Off-label uses of the Pipeline embolization device: a review of the literature

Off-label uses of the Pipeline embolization device: a review of the literature

Endoscopic Endonasal Clipping of Intracranial Aneurysms: Surgical Technique and Results

Endovascular treatment of blister aneurysms

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