Journal article
Early Postmarket Results After Treatment of Intracranial Aneurysms With the Pipeline Embolization Device: A US Multicenter Experience
Neurosurgery, v 71(6), pp 1080-1087
01 Dec 2012
PMID: 22948199
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND: The Pipeline embolization device (PED) is the latest technology available for intracranial aneurysm treatment.
OBJECTIVE: To report early postmarket results with the PED.
METHODS: This study was a prospective registry of patients treated with PEDs at 7 American neurosurgical centers subsequent to Food and Drug Administration approval of this device. Data collected included clinical presentation, aneurysm characteristics, treatment details, and periprocedural events. Follow-up data included degree of aneurysm occlusion and delayed (>30 days after the procedure) complications.
RESULTS: Sixty-two PED procedures were performed to treat 58 aneurysms in 56 patients. Thirty-seven of the aneurysms (64%) treated were located from the cavernous to the superior hypophyseal artery segment of the internal carotid artery; 22% were distal to that segment, and 14% were in the vertebrobasilar system. A total of 123 PEDs were deployed with an average of 2 implanted per aneurysm treated. Six devices were incompletely deployed; in these cases, rescue balloon angioplasty was required. Six periprocedural (during the procedure/within 30 days after the procedure) thromboembolic events occurred, of which 5 were in patients with vertebrobasilar aneurysms. There were 4 fatal postprocedural hemorrhages (from 2 giant basilar trunk and 2 large ophthalmic artery aneurysms). The major complication rate (permanent disability/death resulting from perioperative/delayed complication) was 8.5%. Among 19 patients with 3-month follow-up angiography, 68% (13 patients) had complete aneurysm occlusion. Two patients presented with delayed flow-limiting in-stent stenosis that was successfully treated with angioplasty.
CONCLUSION: Unlike conventional coil embolization, aneurysm occlusion with PED is not immediate. Early complications include both thromboembolic and hemorrhagic events and appear to be significantly more frequent in association with treatment of vertebrobasilar aneurysms.
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Details
- Title
- Early Postmarket Results After Treatment of Intracranial Aneurysms With the Pipeline Embolization Device: A US Multicenter Experience
- Creators
- Peter Kan - Kaleida HealthAdnanH Siddiqui - University at Buffalo, State University of New YorkErol Veznedaroglu - Capital HealthKenneth M. Liebman - Capital HealthMandy J. Binning - Capital HealthTravis M. Dumont - Kaleida HealthChristopher S. Ogilvy - Kaleida HealthJohn R. Gaughen - University of South FloridaJ. Mocco - Vanderbilt UniversityGregory J. Velat - University at Buffalo, State University of New YorkAndrew J. Ringer - Kaleida HealthBabu G. Welch - Capital HealthMichael B. Horowitz - Massachusetts General HospitalKenneth V. Snyder - University at Buffalo, State University of New YorkL. Nelson Hopkins - Kaleida HealthElad I. Levy - University at Buffalo, State University of New York
- Publication Details
- Neurosurgery, v 71(6), pp 1080-1087
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 8
- Grant note
- NINDS 1R01NS064592-01A1 / National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA Toshiba Boston Scientific ev3/Covidien Vascular Therapies St. Jude Medical Abbott Vascular; Abbott Laboratories Codman Shurtleff, Inc
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology; Neurosurgery
- Web of Science ID
- WOS:000311339600021
- Scopus ID
- 2-s2.0-84870064368
- Other Identifier
- 991021918114904721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Surgery