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. 2012 Dec;22(4):295-303.
doi: 10.1007/s00062-012-0178-6. Epub 2012 Nov 3.

Pipeline embolization device for intracranial aneurysm: a systematic review

G K K Leung  1 , A C O Tsang, W M Lui
Affiliations

Pipeline embolization device for intracranial aneurysm: a systematic review

G K K Leung et al. Clin Neuroradiol. 2012 Dec.

Abstract

Introduction: The pipeline embolization device (PED) is a new endovascular stent designed for the treatment of challenging intracranial aneurysms (IAs). Its use has been extended to nonruptured and ruptured IAs of a variety of configurations and etiologies in both the anterior and posterior circulations.

Methods: We conducted a systematic review of ten eligible reports on its clinical efficacy and safety.

Results: There were 414 patients with 448 IAs. The majority of the IAs were large (40.2 %), saccular or blister-like (78.3 %), and were located mostly in the anterior circulation (83.5 %). The regimens of antiplatelet therapy varied greatly between and within studies. The mean number of the PED used was 2.0 per IA. Deployment was successful in around 95 % of procedures. Aneurysm obliteration was achieved in 82.9 % of IAs at 6-month. The overall incidences of periprocedural intracranial vascular complication rate and mortality rate were 6.3 and 1.5 %, respectively.

Conclusion: The PED is a safe and effective treatment for nonruptured IAs. Its use in the context of acute subarachnoid hemorrhage (SAH) should be cautioned. Its main limitations include the need for prolonged antiplatelet therapy, as well as the potential risks of IA rupture and non-IA-related intracerebral hemorrhages (ICH). Future studies should aim at identifying factors that predispose to incomplete obliteration, delayed rupture, and thromboembolic complications.

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References

    1. Ferns SP, Sprengers ME, van Rooij WJ, Rinkel GJ, van Rijn JC, Bipat S. Coiling of intracranial aneurysms: a systematic review on initial occlusion and reopening and retreatment rates. Stroke. 2009;40(8):e523–9. doi: 10.1161/STROKEAHA.109.553099. - DOI - PubMed
    1. Seibert B, Tummala RP, Chow R, Faridar A, Mousavi SA, Divani AA. Intracranial aneurysms: review of current treatment options and outcomes. Front Neurol. 2011;2:45. - PMC - PubMed
    1. Lubicz B, Collignon L, Lefranc F, Bruneau M, Brotchi J, Baleriaux D. Circumferential and fusiform intracranial aneurysms: reconstructive endovascular treatment with self-expandable stents. Neuroradiology. 2008;50(6):499–507. doi: 10.1007/s00234-008-0366-x. - DOI - PubMed
    1. Pierot L, Cognard C, Anxionnat R, Ricolfi F. Endovascular treatment of ruptured intracranial aneurysms: factors affecting midterm quality anatomic results: analysis in a prospective, multicenter series of patients (CLARITY) AJNR Am J Neuroradiol. 2012;33(8):1475–80. doi: 10.3174/ajnr.A3003. - DOI - PMC - PubMed
    1. Gonzalez NR, Duckwiler G, Jahan R, Murayama Y, Vinuela F. Challenges in the endovascular treatment of giant intracranial aneurysms. Neurosurgery. 2008;62(6 Suppl 3):1324–35. - PubMed

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