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Research ArticleInterventional
Open Access

Treatment of Intracranial Aneurysms by Functional Reconstruction of the Parent Artery: The Budapest Experience with the Pipeline Embolization Device

I. Szikora, Z. Berentei, Z. Kulcsar, M. Marosfoi, Z.S. Vajda, W. Lee, A. Berez and P.K. Nelson
American Journal of Neuroradiology June 2010, 31 (6) 1139-1147; DOI: https://doi.org/10.3174/ajnr.A2023
I. Szikora
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Z. Berentei
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Z. Kulcsar
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M. Marosfoi
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Z.S. Vajda
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W. Lee
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A. Berez
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P.K. Nelson
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Abstract

BACKGROUND AND PURPOSE: Aneurysm treatment by intrasaccular packing has been associated with a relatively high rate of recurrence. The use of mesh tubes has recently gained traction as an alternative therapy. This article summarizes the midterm results of using an endoluminal sleeve, the PED, in the treatment of aneurysms.

MATERIALS AND METHODS: A total of 19 wide-neck aneurysms were treated in 18 patients: 10 by implantation of PEDs alone and 9 by a combination of PED and coils. Angiographic and clinical results were recorded immediately and at 6 months following treatment.

RESULTS: Immediate angiographic occlusion was achieved in 4 and flow reduction, in another 15 aneurysms. Angiography at 6 months demonstrated complete occlusion in 17 and partial filling in 1 of 18 patients. There was no difference between coil-packed and unpacked aneurysms. Of 28 side branches covered by ≥1 device, the ophthalmic artery was absent immediately in 1 and at 6 months in another 2 cases. One patient experienced abrupt in-stent thrombosis resulting in a transient neurologic deficit, and 1 patient died due to rupture of a coexisting aneurysm. All giant aneurysms treated with PED alone were demonstrated by follow-up cross-sectional imaging to have involuted by 6 months.

CONCLUSIONS: Treatment of large, wide-neck, or otherwise untreatable aneurysms with functional reconstruction of the parent artery may be achieved with relative safety using dedicated flow-modifying devices with or without adjunctive use of intrasaccular coil packing.

Abbreviations

AICA
anterior inferior cerebellar artery
BA
basilar artery
Immed
Immediate
DSA
digital subtraction angiography
ICA
internal carotid artery
ID
internal diameter
MRA
MR angiography
N/A
not applicable
PcomA
posterior communicating artery
PED
Pipeline Embolization Device
PITA
Pipeline Embolization Device for Intracranial Treatment of Aneurysms
Recan
recanalization
SAH
subarachnoid hemorrhage
SCA
superior cerebellar artery
Sup
superior
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American Journal of Neuroradiology: 31 (6)
American Journal of Neuroradiology
Vol. 31, Issue 6
1 Jun 2010
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Treatment of Intracranial Aneurysms by Functional Reconstruction of the Parent Artery: The Budapest Experience with the Pipeline Embolization Device
I. Szikora, Z. Berentei, Z. Kulcsar, M. Marosfoi, Z.S. Vajda, W. Lee, A. Berez, P.K. Nelson
American Journal of Neuroradiology Jun 2010, 31 (6) 1139-1147; DOI: 10.3174/ajnr.A2023

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Treatment of Intracranial Aneurysms by Functional Reconstruction of the Parent Artery: The Budapest Experience with the Pipeline Embolization Device
I. Szikora, Z. Berentei, Z. Kulcsar, M. Marosfoi, Z.S. Vajda, W. Lee, A. Berez, P.K. Nelson
American Journal of Neuroradiology Jun 2010, 31 (6) 1139-1147; DOI: 10.3174/ajnr.A2023
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