Pipeline Embolization Device in treatment of 50 unruptured large and giant aneurysms.

Pipeline Embolization Device in treatment of 50 unruptured large and giant aneurysms.

World Neurosurg. 2017 May 31;:

Authors: Adeeb N, Griessenauer CJ, Shallwani H, Shakir H, Foreman PM, Moore JM, Dmytriw A, Gupta R, Siddiqui AH, Levy EI, Snyder K, Harrigan MR, Ogilvy CS, Thomas AJ

Abstract
INTRODUCTION: Treatment of large (≥ 20 mm) and giant (≥ 25 mm) intracranial aneurysms is challenging, and can be associated with a high rate of morbidity and mortality. The Pipeline Embolization Device (PED) has been effectively used for the treatment of intracranial aneurysms achieving a high rate of complete occlusion. However, its safety and efficacy in treatment of large and giant aneurysms has not been fully evaluated.
METHODS: A retrospective analysis of consecutive aneurysms treated with PED between 2009 and 2016 at three academic institutions within the United States was performed. Large (≥ 20 mm) and giant (≥ 25 mm) were selected for evaluation of occlusion and complication rates associated with PED placement.
RESULTS: A total of 50 large and giant aneurysms were individually treated using PED. Aneurysms were fusiform (74%) or saccular (26%) in morphology. PED alone was used for treating 78% of the aneurysms, while PED with adjunctive coiling was used for treating 22%. The median length of angiographic follow-up was 13 months (mean 20.4 months). At last follow-up, complete or near complete occlusion (90-100%) was achieved in 76.9% of aneurysms. Symptomatic thromboembolic complications were encountered in 12% of procedures and symptomatic hemorrhagic complications in 8%.
CONCLUSION: The use of PED for treatment of large and giant intracranial aneurysms is associated with good occlusion rate, but higher complication rate compared to aneurysms smaller in size. There was no significant difference in occlusion rate based on aneurysm shape and size, number of PEDs placed, or adjunctive coiling.

PMID: 28578117 [PubMed - as supplied by publisher]

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