Dataset on flow diversion procedures performed with the Pipeline Embolization Device, Pipeline Flex, and Surpass Streamline for intracranial aneurysms

Abstract

Flow diversion is an evolving endovascular modality for treating intracranial aneurysms. Although rare, serious adverse events following flow diversion may include ischemic stroke, intracranial hemorrhage, or delayed rupture of the treated aneurysm. This dataset describes 141 flow diversion procedures performed with the Pipeline Embolization Device, Pipeline Flex, or Surpass Streamline on 126 subjects with intracranial aneurysms [1]. The retrospective data were collected from electronic medical records at two large tertiary centers. Baseline patient data included age, sex, and medical comorbidities. The dataset also describes aneurysm characteristics including laterality, anatomic location, morphology, dome height, and neck width. In addition, digital subtraction images showing the internal carotid artery tortuosity were included for aneurysms in the anterior cerebral circulation [2]. Procedural data include case duration, radiation exposure, number of flow diverters deployed, and complications encountered during deployment. In addition, data related to the duration of hospitalization and postoperative adverse events are included. Finally, time to follow up and rates of total aneurysm obliteration at first and second postoperative visits are included. This data is propensity score matching are included. This data is presented as a starting point for future prospective comparisons in the safety and efficacy of flow diverters as more devices become approved and commercially available.

Keywords: Aneurysm; DSA, digital subtraction angiography; Flow diversion; PED, Pipeline Embolization Device; Pipeline embolization; Stroke; Subarachnoid hemorrhage; cICA, cavernous portion of the internal carotid artery.

Fig. 1

Aneurysm characteristics example. This is a case of a 63-year-old female with a history of hypertension who was found to have a 6.0 × 5.5 mm saccular aneurysm located in the paraophthalmic segment of the right internal carotid artery found incidentally during work-up for acute, severe headache. Flow diversion was achieved using a 3 × 20 mm Surpass Streamline. (A) Digital subtraction angiography showing a lateral view of the right internal carotid artery. The yellow arrow points to the saccular aneurysm in the paraophthalmic segment. (B) Anterior-posterior view of 3D-reconstructed digital subtraction angiography. The yellow arrow points to the saccular aneurysm, with the dome projecting medially.

Fig. 2

Aneurysm dimension measurement example. This is a case of a 70-year-old female with a history of hypertension, hyperlipidemia, smoking, and type 2 diabetes mellitus in whom a bilobed 3.0 × 5.6 mm aneurysm was identified in the cavernous segment of the right internal carotid artery after a syncopal episode. Flow diversion was achieved using a 5 × 12 mm Pipeline Embolization Device. The image shows the anterior-posterior view of a 3D reconstruction of digital subtraction angiography. The measurement of the aneurysm height (orange line and text), dome width (light green line and text), and neck width (dark green line and text) are displayed.