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Complex cerebral aneurysms: intra-luminal reconstruction using Pipeline flow-diverting stent and the obliteration mechanism
- Source :
- Neuroradiol J
- Publication Year :
- 2019
- Publisher :
- SAGE Publications, 2019.
-
Abstract
- Objectives Patients with complex cerebral aneurysms can now be treated intravascularly with the help of flow-diverting stents. The primary purpose of this article is to document the clinical and angiographic outcomes in 80 patients who were treated with the Pipeline flow-diverting stent (PFS; Medtronic, Dublin, Ireland) and the obliteration mechanism was discussed. Patients and methods Between October 2015 and October 2019, 80 patients with 90 complex (undefined neck, large/giant, blood blister–like, and recurrent side-wall) cerebral aneurysms treated with the PFS were retrospectively reviewed. Forty-five patients were women and 35 were men, with a mean age of 52 years. Large or giant aneurysms were defined as 10 mm or larger and small aneurysms were defined as less than 10 mm at the largest diameter measured on angiogram. Results Forty-one aneurysms (45.6%) were large or giant, 41 (45.6%) were small, four (4.4%) were recurrent side-wall aneurysms and four (4.4%) were blood blister–like aneurysms. In total, 87 PFSs were placed in 80 patients with 90 aneurysms. In six patients, coexisting proximal stenosis of parent artery was also covered with PFS without balloon angioplasty. Adjunct coils were placed in 31 aneurysms (34%). One patient died of intracerebral hematoma after thrombolysis. There was one intrastent occlusion at six-month follow-up without any symptoms. The morbidity and the mortality rate is 0% and 1.3% (95% confidence interval (CI), 0%–3.7%). Control angiography was available in 74 (92.5%) patients with 83 aneurysms, and the aneurysm occlusion rate was 98.8% (95% CI, 96.5%–100%) in 6 to 12 months. Conclusion For wide-necked saccular, large/giant, blood blister–like aneurysms and recurrent side-wall aneurysms, PFS is a valid and safe treatment option.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Cerebrovascular Diseases
030218 nuclear medicine & medical imaging
Young Adult
03 medical and health sciences
0302 clinical medicine
Aneurysm
Flow diverting stent
medicine
Humans
Radiology, Nuclear Medicine and imaging
cardiovascular diseases
Aged
Retrospective Studies
business.industry
Mechanism (biology)
Endovascular Procedures
Intracranial Aneurysm
General Medicine
Middle Aged
medicine.disease
Embolization, Therapeutic
Pipeline (software)
Cerebral Angiography
Treatment Outcome
cardiovascular system
Female
Stents
Neurology (clinical)
Radiology
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 23851996 and 19714009
- Volume :
- 33
- Database :
- OpenAIRE
- Journal :
- The Neuroradiology Journal
- Accession number :
- edsair.doi.dedup.....a7142fd79b8dca5d356f41d9ea3b768c