Use of the Pipeline embolization device for recurrent and residual cerebral aneurysms: A safety and efficacy analysis with short-term follow-up

Anna Luisa Kühn, Katyucia De Macedo Rodrigues, J. Diego Lozano, David E. Rex, Francesco Massari, Takamitsu Tamura, Mary Howk, Christopher Brooks, Jenna L'Heureux, Matthew J. Gounis, Ajay K. Wakhloo, Ajit S. Puri

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)

Abstract

Objective Evaluation of the safety and efficacy of the Pipeline embolization device (PED) when used as second-line treatment for recurrent or residual, pretreated ruptured and unruptured intracranial aneurysms (IAs). Methods Retrospective review of our database to include all patients who were treated with a PED for recurrent or residual IAs following surgical clipping or coiling. We evaluated neurological outcome and angiograms at discharge, 6- and 12-months' follow-up and assessed intimal hyperplasia at follow-up. Results Twenty-four patients met our inclusion criteria. Most IAs were located in the anterior circulation (n=21). No change of preprocedure modified Rankin Scale score was seen at discharge or at any scheduled follow-up. Complete or near-complete aneurysm occlusion on 6- and 12-month angiograms was seen in 94.4% (17/18 cases) and 93.3% (14/15 cases), respectively. Complete or near-complete occlusion was seen in 100% of previously ruptured and 85.7% (6/7 cases) and 83.3% (5/6 cases) of previously unruptured cases at the 6- and 12-months' follow-up, respectively. One case of moderate intimal hyperplasia was observed at 6months and decreased to mild at the 12-months' follow-up. No difference in device performance was observed among pretreated unruptured or ruptured IAs. Conclusions Treatment of recurrent or residual IAs with a PED after previous coiling or clipping is feasible and safe. There is no difference in device performance between ruptured or unruptured IAs.

Original languageEnglish
Pages (from-to)1208-1213
Number of pages6
JournalJournal of NeuroInterventional Surgery
Volume9
Issue number12
DOIs
Publication statusPublished - 01-12-2017
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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