Title

Use of the Pipeline embolization device for recurrent and residual cerebral aneurysms: a safety and efficacy analysis with short-term follow-up

Authors

Anna L. Kuhn, University of Massachusetts Medical SchoolFollow
Katyucia de Macedo Rodrigues, University of Massachusetts Medical School
Juan Diego Lozano, University of Massachusetts Medical School
David E. Rex, University of Massachusetts Medical SchoolFollow
Francesco Massari, University of Massachusetts Medical SchoolFollow
Takamitsu Tamura, University of Massachusetts Medical SchoolFollow
Mary Howk, University of Massachusetts Medical School
Christopher Brooks, University of Massachusetts Medical SchoolFollow
Jenna L'Heureux, University of Massachusetts Medical SchoolFollow
Matthew J. Gounis, University of Massachusetts Medical SchoolFollow
Ajay K. Wakhloo, University of Massachusetts Medical School
Ajit S. Puri, University of Massachusetts Medical SchoolFollow

UMMS Affiliation

Division of Neuroimaging and Intervention, Department of Radiology; New England Center for Stroke Research

Publication Date

2017-12-01

Document Type

Article

Disciplines

Cardiovascular Diseases | Nervous System Diseases | Neurology | Radiology | Surgery

Abstract

OBJECTIVE: Evaluation of the safety and efficacy of the Pipeline embolization device (PED) when used as second-line treatment for recurrent or residual, pretreated ruptured and unruptured intracranial aneurysms (IAs).

METHODS: Retrospective review of our database to include all patients who were treated with a PED for recurrent or residual IAs following surgical clipping or coiling. We evaluated neurological outcome and angiograms at discharge, 6- and 12-months' follow-up and assessed intimal hyperplasia at follow-up.

RESULTS: Twenty-four patients met our inclusion criteria. Most IAs were located in the anterior circulation (n=21). No change of preprocedure modified Rankin Scale score was seen at discharge or at any scheduled follow-up. Complete or near-complete aneurysm occlusion on 6- and 12-month angiograms was seen in 94.4% (17/18 cases) and 93.3% (14/15 cases), respectively. Complete or near-complete occlusion was seen in 100% of previously ruptured and 85.7% (6/7 cases) and 83.3% (5/6 cases) of previously unruptured cases at the 6- and 12-months' follow-up, respectively. One case of moderate intimal hyperplasia was observed at 6 months and decreased to mild at the 12-months' follow-up. No difference in device performance was observed among pretreated unruptured or ruptured IAs.

CONCLUSIONS: Treatment of recurrent or residual IAs with a PED after previous coiling or clipping is feasible and safe. There is no difference in device performance between ruptured or unruptured IAs.

Keywords

Aneurysm, Coil, Flow Diverter, Intervention

DOI of Published Version

10.1136/neurintsurg-2016-012772

Source

J Neurointerv Surg. 2017 Dec;9(12):1208-1213. doi: 10.1136/neurintsurg-2016-012772. Epub 2016 Nov 25. Link to article on publisher's site

Journal/Book/Conference Title

Journal of neurointerventional surgery

Related Resources

Link to Article in PubMed

PubMed ID

27888225

Repository Citation

Kuhn AL, de Macedo Rodrigues K, Lozano JD, Rex DE, Massari F, Tamura T, Howk M, Brooks C, L'Heureux J, Gounis MJ, Wakhloo AK, Puri AS. (2017). Use of the Pipeline embolization device for recurrent and residual cerebral aneurysms: a safety and efficacy analysis with short-term follow-up. Radiology Publications. https://doi.org/10.1136/neurintsurg-2016-012772. Retrieved from https://escholarship.umassmed.edu/radiology_pubs/407