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Utilization of Pipeline embolization device for treatment of ruptured intracranial aneurysms: US multicenter experience
- Source :
- Journal of neurointerventional surgery. 7(11)
- Publication Year :
- 2014
-
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.
- Subjects :
- Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Thromboembolic stroke
Aneurysm, Ruptured
Asymptomatic
Aneurysm
Postoperative Complications
Modified Rankin Scale
Outcome Assessment, Health Care
medicine
Humans
cardiovascular diseases
Embolization
Intraoperative Complications
Aged
medicine.diagnostic_test
business.industry
Intracranial Aneurysm
General Medicine
Clipping (medicine)
Middle Aged
medicine.disease
Embolization, Therapeutic
United States
Surgery
Stenosis
Angiography
Female
Neurology (clinical)
Radiology
medicine.symptom
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 17598486
- Volume :
- 7
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- Journal of neurointerventional surgery
- Accession number :
- edsair.doi.dedup.....3de5fdf30a37ab7eb1e8671a174967bb