Use of pipeline flow diverting stents for wide neck intracranial aneurysms: A retrospective institutional review
- PMID: 24891883
- PMCID: PMC4038863
- DOI: 10.4103/1793-5482.131057
Use of pipeline flow diverting stents for wide neck intracranial aneurysms: A retrospective institutional review
Abstract
Background: Intracranial aneurysms (ICA) if inadequately treated may result in serious morbidity and mortality. Wide-neck; large/giant, fusiform, and dissecting aneurysms are not well treated using the conventional coil embolization technique. Recent advance in endovascular treatment and technology has introduced flow diverter devices including pipeline embolization devices (PED) and Silk stents that have been shown to be more effective in treating these more complicated aneurysms. Flow Diverter devices offer a more physiologic approach to ICA treatment.
Methods: We conducted a retrospective chart review of 23 adult patients who underwent aneurysm treatment utilizing the pipeline stent at Duke University Medical Center from July 2011 to March 2013.
Results: Majority of patients (19, 82.7%) showed angiographic evidence of complete obliteration of aneurysm at 6 months follow-up, with sustained clinical improvement on modified Rankin scale score. All of the patients tolerated the procedure well with no intra-operative hemorrhage or intra-operative thromboembolic complications.
Conclusions: Our experience shows that use of PED offers a safe and effective strategy for treatment of complex ICA. Larger prospective studies are needed to confirm these observations.
Keywords: Flow diverter; intracranial aneurysm; pipeline device.
Conflict of interest statement
Similar articles
-
Sole stenting with large cell stents for very small ruptured intracranial aneurysms.Interv Neuroradiol. 2014 Jan-Feb;20(1):45-53. doi: 10.15274/INR-2014-10007. Epub 2014 Feb 10. Interv Neuroradiol. 2014. PMID: 24556299 Free PMC article.
-
Pipeline for uncoilable or failed aneurysms: 3-year follow-up results.J Neurosurg. 2017 Jul;127(1):81-88. doi: 10.3171/2015.6.JNS15311. Epub 2016 Oct 14. J Neurosurg. 2017. PMID: 27739944
-
Flow diverter devices in ruptured intracranial aneurysms: a single-center experience.J Neurosurg. 2018 Apr;128(4):1037-1043. doi: 10.3171/2016.11.JNS161937. Epub 2017 Apr 7. J Neurosurg. 2018. PMID: 28387623
-
Endovascular treatment of complex intracranial aneurysms by pipeline flow-diverter embolization device: a single-center experience.Neurol Res. 2015 Apr;37(4):359-65. doi: 10.1179/1743132814Y.0000000450. Epub 2014 Oct 13. Neurol Res. 2015. PMID: 25310354 Review.
-
Quantitative Assessment of In-Stent Stenosis After Pipeline Embolization Device Treatment of Intracranial Aneurysms: A Single-Institution Series and Systematic Review.World Neurosurg. 2018 Dec;120:e1031-e1040. doi: 10.1016/j.wneu.2018.08.225. Epub 2018 Sep 7. World Neurosurg. 2018. PMID: 30201581
Cited by
-
Endosurgical Remodeling of Wide-Necked Bifurcation Aneurysms.Front Neurol. 2019 Mar 20;10:245. doi: 10.3389/fneur.2019.00245. eCollection 2019. Front Neurol. 2019. PMID: 30949119 Free PMC article.
-
Comparison of endovascular treatment for middle cerebral artery aneurysm with a low-profile visualized intraluminal support stent or pipeline embolization device.Exp Ther Med. 2019 Sep;18(3):2072-2078. doi: 10.3892/etm.2019.7775. Epub 2019 Jul 16. Exp Ther Med. 2019. PMID: 31410163 Free PMC article.
-
Microcatheter-guided compartment packing of acutely ruptured complex intracerebral aneurysms (ARCIAs): Preliminary experience and technical note.Front Neurol. 2022 Nov 23;13:1020013. doi: 10.3389/fneur.2022.1020013. eCollection 2022. Front Neurol. 2022. PMID: 36504653 Free PMC article.
References
-
- Investigators UJ, Morita A, Kirino T, Hashi K, Aoki N, Fukuhara S, et al. The natural course of unruptured cerebral aneurysms in a Japanese cohort. The New England Journal of Medicine. 2012;366:2474–82. - PubMed
-
- Koebbe CJ, Veznedaroglu E, Jabbour P, Rosenwasser RH. Endovascular management of intracranial aneurysms: Current experience and future advances. Neurosurgery. 2006;59:S93–102. discussion S3-13. - PubMed
-
- Naggara ON, Lecler A, Oppenheim C, Meder JF, Raymond J. Endovascular treatment of intracranial unruptured aneurysms: A systematic review of the literature on safety with emphasis on subgroup analyses. Radiology. 2012;263:828–35. - PubMed
-
- Piano M, Valvassori L, Quilici L, Pero G, Boccardi E. Midterm and long-term follow-up of cerebral aneurysms treated with flow diverter devices: A single-center experience. Journal of Neurosurgery. 2013;118:408–16. - PubMed
LinkOut - more resources
Full Text Sources
Other Literature Sources
Miscellaneous