Safety, efficacy, and short-term follow-up of the use of Pipeline Embolization Device in small (<2.5 mm) cerebral vessels for aneurysm treatment: single institution experience.

Authors

Ajit S Puri
Francesco Massari
Takumi Asai
Miklos Marosfoi
Peter Kan
Samuel Y Hou, Stroke and Neurovascular Center of Central California, Santa Barbara, CA, USA.Follow
Mary Howk
Mary Perras
Christopher Brooks
Frederic Clarencon
Matthew J Gounis
Ajay K Wakhloo

Document Type

Article

Publication Date

3-1-2016

Publication Title

Neuroradiology

Keywords

Aged; Blood Vessel Prosthesis; Embolization, Therapeutic; Equipment Failure Analysis; Female; Follow-Up Studies; Humans; Intracranial Aneurysm; Longitudinal Studies; Male; Middle Aged; Prosthesis Design; Stents; Treatment Outcome

Abstract

INTRODUCTION: Flow diversion is being increasingly used to treat cerebral aneurysms. We present our experience using these stents to treat aneurysms distal to the circle of Willis with parent arteries smaller than 2.5 mm.

METHODS: Aneurysms treated with a Pipeline Embolization Device in vessels less than 2.5 mm between June 2012 and August 2014 were included. We evaluated risk factors, family history of aneurysms, aneurysm characteristics, National Institute of Health Stroke Scale (NIHSS), and modified Rankin scale (mRS) on admission and angiography and clinical outcome at discharge, 6 months, and 1 year.

RESULTS: We included seven patients with a mean age of 65 years. The parent vessel size ranged from 1.5 to 2.3 mm; mean 1.9 mm. Location of the aneurysms was as follows: two aneurysms centered along the pericallosal artery (one left, one right), one on the right angular artery, one aneurysm at the anterior communicating artery (ACom), one at the ACom-right A2 anterior cerebral artery (ACA), one at the lenticulostriate artery, and one at the A1-A2 ACA artery. Aneurysms ranged from 1 to 12 mm in diameter. All aneurysms were treated with a single Pipeline Embolization Device (PED). No peri- or post-procedural complications or mortality occurred. The patients were discharged with no change in NIHSS or mRS score. Angiographic follow-up was available in six patients. Angiography showed complete aneurysm occlusion in all. NIHSS and mRS remained unchanged at follow-up.

CONCLUSION: Our preliminary results show that flow diversion technology is an effective and safe therapy for aneurysms located on small cerebral arteries. Larger studies with long-term follow-up are needed to validate our promising results.

Clinical Institute

Neurosciences (Brain & Spine)

Department

Neurosciences

Comments

Samuel Hou is affiliated with Providence St. Joseph Health.

Recommended Citation

Puri, Ajit S; Massari, Francesco; Asai, Takumi; Marosfoi, Miklos; Kan, Peter; Hou, Samuel Y; Howk, Mary; Perras, Mary; Brooks, Christopher; Clarencon, Frederic; Gounis, Matthew J; and Wakhloo, Ajay K, "Safety, efficacy, and short-term follow-up of the use of Pipeline Embolization Device in small (<2.5 mm) cerebral vessels for aneurysm treatment: single institution experience." (2016). Articles, Abstracts, and Reports. 873.
https://digitalcommons.providence.org/publications/873