Journal article
Utilization of Pipeline embolization device for treatment of ruptured intracranial aneurysms: US multicenter experience
Journal of neurointerventional surgery, v 7(11), pp 808-815
01 Nov 2015
PMID: 25230839
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objective Utilization of the Pipeline embolization device (PED) in complex ruptured aneurysms has not been well studied. We evaluated the safety and effectiveness data from five participating US centers.
Methods Records of patients with ruptured cerebral aneurysms who underwent PED treatment between 2011 and 2013 were retrospectively reviewed.
Results 26 patients with ruptured aneurysms underwent PED treatment (mean age 51.4 +/- 13.2 years;16 women). At presentation, 8 patients (30.8%) had a Hunt-Hess grade of IV or above; 11 required extraventricular drain placement. Aneurysm morphologies were: 8 dissecting, 8 blister-like, 6 fusiform, and 4 saccular. There were 22 anterior circulation and 4 posterior circulation aneurysms. PED deployment was successful in all patients, with adjunctive coiling utilized in 12. Periprocedural complications occurred in 5(19.2%), including 3 inhospital deaths. 23 patients (88.5%) had postoperative angiography at a mean of 5,9 months: 18 aneurysms (78.3%) were completely occluded, 3(13.0%) had residual neck filling, and 2 (8.7%) had residual dome filling. All blister-type aneurysms were completely occluded at follow-up. Clinical follow-up was available for an average of 10.1 months (range 2-21 months), with one asymptomatic in-stent stenosis and one asymptomatic thromboembolic stroke noted. Good outcome (modified Rankin Scale (mRS) score of 0-2) was achieved in 20 patients (76.9%), fair (mRS 3-4) in 3 (11.5%), and 3 died (11.5%).
Conclusions 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.
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Details
- Title
- Utilization of Pipeline embolization device for treatment of ruptured intracranial aneurysms: US multicenter experience
- Creators
- Ning Lin - University at Buffalo, State University of New YorkAdam M. Brouillard - University at Buffalo, State University of New YorkKiffon M. Keigher - Rush University Medical CenterDemetrius K. Lopes - Rush University Medical CenterMandy J. Binning - Capital HealthKenneth M. Liebman - Capital HealthErol Veznedaroglu - Capital HealthJordan A. Magarik - Vanderbilt University Medical CenterJ. Mocco - Vanderbilt University Medical CenterEdward A. Duckworth - University of Tennessee at KnoxvilleAdam S. Arthur - Semmes Murphey FoundationAndrew J. Ringer - Mayfield Brain & SpineKenneth V. Snyder - University at Buffalo, State University of New YorkElad I. Levy - University at Buffalo, State University of New YorkAdnan H. Siddiqui - University at Buffalo, State University of New York
- Publication Details
- Journal of neurointerventional surgery, v 7(11), pp 808-815
- Publisher
- Bmj Publishing Group
- Number of pages
- 8
- Grant note
- Stryker Neurovascular Toshiba Zimmer Siemens AG 1U01NS086492-01; 1R01NS078828-01A1 / NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA University at Buffalo Stryker MicroVention Terumo MicroVention Medtronic
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology; Neurosurgery
- Web of Science ID
- WOS:000364251500006
- Scopus ID
- 2-s2.0-84945196965
- Other Identifier
- 991021918115004721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Neuroimaging
- Surgery