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Long-Term Follow-Up after Treatment of Intracranial Aneurysms with the Pipeline Embolization Device: Results from a Single Center

Long-Term Follow-Up after Treatment of Intracranial Aneurysms with the Pipeline Embolization... BACKGROUND AND PURPOSE: Stent-like, self-expandable devices, the so-called flow diverters, are increasingly used for the treatment of wide-neck cerebral aneurysms. The immediate and short-term results are promising, but no long-term results are available. The purpose of our research was to report the long-term angiographic and cross-sectional imaging results after placement of a PED in 12 patients with wide-neck intracranial aneurysms. MATERIALS AND METHODS: Twelve wide-neck or otherwise untreatable cerebral aneurysms in 12 patients were treated with the PED. Angiography was performed at 6 and 24 months after treatment. Additional MR and CT angiograms were acquired. RESULTS: In all patients, angiographic or cross-sectional imaging follow-up of at least 27 months demonstrated complete occlusion of the aneurysms treated with the PED. There were no cases of aneurysm recurrence. Angiography at around 6 months showed complete occlusion in all cases, except 1 that showed complete occlusion at the 29-month follow-up. In 1 patient, a clinically asymptomatic 75% in-stent stenosis was seen on the angiography at 6 months but was resolved completely by balloon dilation. Device placement was successful in all patients. Distal embolization had occurred in 1 patient, but the clot was resolved completely without clinical sequelae. Almost immediate angiographic occlusion was achieved in 2 aneurysms and flow reduction in 10 aneurysms. CONCLUSIONS: Treatment of wide-neck intracranial aneurysms by PED placement led to successful and durable occlusion in all cases, without severe complications. Endovascular treatment for in-stent stenosis should be considered cautiously, because the underlying stenosis may be transient and disappear within 12 months after treatment. ABBREVIATIONS: CPR curved planar reconstruction GOS Glasgow Outcome Scale PcomA posterior communicating artery PED Pipeline Embolization Device PITA Pipeline for the Intracranial Treatment of Aneurysms http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Long-Term Follow-Up after Treatment of Intracranial Aneurysms with the Pipeline Embolization Device: Results from a Single Center

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Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2012 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A2790
pmid
22158922
Publisher site
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Abstract

BACKGROUND AND PURPOSE: Stent-like, self-expandable devices, the so-called flow diverters, are increasingly used for the treatment of wide-neck cerebral aneurysms. The immediate and short-term results are promising, but no long-term results are available. The purpose of our research was to report the long-term angiographic and cross-sectional imaging results after placement of a PED in 12 patients with wide-neck intracranial aneurysms. MATERIALS AND METHODS: Twelve wide-neck or otherwise untreatable cerebral aneurysms in 12 patients were treated with the PED. Angiography was performed at 6 and 24 months after treatment. Additional MR and CT angiograms were acquired. RESULTS: In all patients, angiographic or cross-sectional imaging follow-up of at least 27 months demonstrated complete occlusion of the aneurysms treated with the PED. There were no cases of aneurysm recurrence. Angiography at around 6 months showed complete occlusion in all cases, except 1 that showed complete occlusion at the 29-month follow-up. In 1 patient, a clinically asymptomatic 75% in-stent stenosis was seen on the angiography at 6 months but was resolved completely by balloon dilation. Device placement was successful in all patients. Distal embolization had occurred in 1 patient, but the clot was resolved completely without clinical sequelae. Almost immediate angiographic occlusion was achieved in 2 aneurysms and flow reduction in 10 aneurysms. CONCLUSIONS: Treatment of wide-neck intracranial aneurysms by PED placement led to successful and durable occlusion in all cases, without severe complications. Endovascular treatment for in-stent stenosis should be considered cautiously, because the underlying stenosis may be transient and disappear within 12 months after treatment. ABBREVIATIONS: CPR curved planar reconstruction GOS Glasgow Outcome Scale PcomA posterior communicating artery PED Pipeline Embolization Device PITA Pipeline for the Intracranial Treatment of Aneurysms

Journal

American Journal of Neuroradiology – American Journal of Neuroradiology

Published: Mar 1, 2012

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