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. 2017 Aug:104:205-212.
doi: 10.1016/j.wneu.2017.04.111. Epub 2017 Apr 27.

Factors Affecting the Obliteration Rate of Intracranial Aneurysms Treated with a Single Pipeline Embolization Device

Hanieh Moshayedi  1 , Oluwaseun A Omofoye  2 , Edward Yap  3 , Taofik O Oyekunle  4 , Deanna M Sasaki-Adams  3 , Sten Y Solander  1
Affiliations

Factors Affecting the Obliteration Rate of Intracranial Aneurysms Treated with a Single Pipeline Embolization Device

Hanieh Moshayedi et al. World Neurosurg. 2017 Aug.

Abstract

Objective: To evaluate the clinical and angiographic outcomes of intracranial aneurysm treatment using a single Pipeline embolization device (PED), and to evaluate the factors affecting aneurysm obliteration rate.

Methods: The demographic characteristics and anatomic features of 58 aneurysms in 47 patients treated with a single PED were reviewed retrospectively. All aneurysms treated with a PED at a single center and with follow-up angiograms for at least 6 months were included in this study.

Results: The overall rate of complete and near-complete occlusion was 84% (49 of 58) after a mean follow-up period of 18.3 months. The rate of complete aneurysm obliteration was lower in aneurysms with an arterial branch arising from the aneurysm neck compared with aneurysms without an arterial branch (13% [1 of 8] vs. 68% [34 of 50]; P = 0.0075). The overall rate of complete and near-complete aneurysm occlusion was 90% (45 of 50) in aneurysms without an arterial branch arising from its neck. There were no statistically significant associations between obliteration rate and aneurysm neck width, size, or type, or history of previous coil embolization.

Conclusions: Our data suggest that a single PED is sufficient to induce complete or near-complete obliteration of most aneurysms. The presence of a branching artery arising from the aneurysm neck is highly predictive of incomplete occlusion after treatment with a single PED.

Keywords: Flow diversion; Intracranial aneurysm; Occlusion rate; Pipeline embolization device.

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Conflict of interest statement

DISCLOSURE

Dr. Solander is a proctor in the use of the Pipeline Embolization Device for Medtronic. The other authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

Figures

FIG. 1
FIG. 1
A-D: Cerebral angiogram (lateral view of the right internal carotid artery injection). A: shows a right ophthalmic segment aneurysm. B: shows stagnation of blood in the aneurysm after deploying the PED. C, D: 6-month follow-up angiogram showing complete obliteration of the right ophthalmic segment aneurysm
FIG. 1
FIG. 1
A-D: Cerebral angiogram (lateral view of the right internal carotid artery injection). A: shows a right ophthalmic segment aneurysm. B: shows stagnation of blood in the aneurysm after deploying the PED. C, D: 6-month follow-up angiogram showing complete obliteration of the right ophthalmic segment aneurysm
FIG. 1
FIG. 1
A-D: Cerebral angiogram (lateral view of the right internal carotid artery injection). A: shows a right ophthalmic segment aneurysm. B: shows stagnation of blood in the aneurysm after deploying the PED. C, D: 6-month follow-up angiogram showing complete obliteration of the right ophthalmic segment aneurysm
FIG. 1
FIG. 1
A-D: Cerebral angiogram (lateral view of the right internal carotid artery injection). A: shows a right ophthalmic segment aneurysm. B: shows stagnation of blood in the aneurysm after deploying the PED. C, D: 6-month follow-up angiogram showing complete obliteration of the right ophthalmic segment aneurysm
FIG. 2
FIG. 2
A-D: Cerebral angiogram (lateral view of the left internal carotid artery injection). A: shows a left ophthalmic segment aneurysm with the ophthalmic artery arising from neck of the aneurysm. B: 1-year follow-up angiogram showing little change in size of the left ophthalmic segment aneurysm. C, D: 2.5-year follow-up angiogram showing contrast stagnation in the aneurysm remnant and patent left ophthalmic artery
FIG. 2
FIG. 2
A-D: Cerebral angiogram (lateral view of the left internal carotid artery injection). A: shows a left ophthalmic segment aneurysm with the ophthalmic artery arising from neck of the aneurysm. B: 1-year follow-up angiogram showing little change in size of the left ophthalmic segment aneurysm. C, D: 2.5-year follow-up angiogram showing contrast stagnation in the aneurysm remnant and patent left ophthalmic artery
FIG. 2
FIG. 2
A-D: Cerebral angiogram (lateral view of the left internal carotid artery injection). A: shows a left ophthalmic segment aneurysm with the ophthalmic artery arising from neck of the aneurysm. B: 1-year follow-up angiogram showing little change in size of the left ophthalmic segment aneurysm. C, D: 2.5-year follow-up angiogram showing contrast stagnation in the aneurysm remnant and patent left ophthalmic artery
FIG. 2
FIG. 2
A-D: Cerebral angiogram (lateral view of the left internal carotid artery injection). A: shows a left ophthalmic segment aneurysm with the ophthalmic artery arising from neck of the aneurysm. B: 1-year follow-up angiogram showing little change in size of the left ophthalmic segment aneurysm. C, D: 2.5-year follow-up angiogram showing contrast stagnation in the aneurysm remnant and patent left ophthalmic artery
See this image and copyright information in PMC

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