Skip to main content
Advertisement

Main menu

  • Home
  • Content
    • Current Issue
    • Publication Preview--Ahead of Print
    • Past Issue Archive
    • Case of the Week Archive
    • Classic Case Archive
    • Case of the Month Archive
  • For Authors
  • About Us
    • About AJNR
    • Editors
    • American Society of Neuroradiology
  • Submit a Manuscript
  • Podcasts
    • Subscribe on iTunes
    • Subscribe on Stitcher
  • More
    • Subscribers
    • Permissions
    • Advertisers
    • Alerts
    • Feedback
  • Other Publications
    • ajnr

User menu

  • Subscribe
  • Alerts
  • Log in

Search

  • Advanced search
American Journal of Neuroradiology
American Journal of Neuroradiology

American Journal of Neuroradiology

  • Subscribe
  • Alerts
  • Log in

Advanced Search

  • Home
  • Content
    • Current Issue
    • Publication Preview--Ahead of Print
    • Past Issue Archive
    • Case of the Week Archive
    • Classic Case Archive
    • Case of the Month Archive
  • For Authors
  • About Us
    • About AJNR
    • Editors
    • American Society of Neuroradiology
  • Submit a Manuscript
  • Podcasts
    • Subscribe on iTunes
    • Subscribe on Stitcher
  • More
    • Subscribers
    • Permissions
    • Advertisers
    • Alerts
    • Feedback
  • Follow AJNR on Twitter
  • Visit AJNR on Facebook
  • Follow AJNR on Instagram
  • Join AJNR on LinkedIn
  • RSS Feeds
Research ArticleInterventional

Predictors of Incomplete Occlusion following Pipeline Embolization of Intracranial Aneurysms: Is It Less Effective in Older Patients?

N. Adeeb, J.M. Moore, M. Wirtz, C.J. Griessenauer, P.M. Foreman, H. Shallwani, R. Gupta, A.A. Dmytriw, R. Motiei-Langroudi, A. Alturki, M.R. Harrigan, A.H. Siddiqui, E.I. Levy, A.J. Thomas and C.S. Ogilvy
American Journal of Neuroradiology December 2017, 38 (12) 2295-2300; DOI: https://doi.org/10.3174/ajnr.A5375
N. Adeeb
aFrom the Neurosurgical Service (N.A., J.M.M., M.W., C.J.G., R.G., A.A.D., R.M.-L., A.A., A.J.T., C.S.O.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
dDepartment of Neurosurgery (N.A.), Louisiana State University, Shreveport, Louisiana.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for N. Adeeb
J.M. Moore
aFrom the Neurosurgical Service (N.A., J.M.M., M.W., C.J.G., R.G., A.A.D., R.M.-L., A.A., A.J.T., C.S.O.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for J.M. Moore
M. Wirtz
aFrom the Neurosurgical Service (N.A., J.M.M., M.W., C.J.G., R.G., A.A.D., R.M.-L., A.A., A.J.T., C.S.O.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for M. Wirtz
C.J. Griessenauer
aFrom the Neurosurgical Service (N.A., J.M.M., M.W., C.J.G., R.G., A.A.D., R.M.-L., A.A., A.J.T., C.S.O.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for C.J. Griessenauer
P.M. Foreman
bDepartment of Neurosurgery (P.M.F., M.R.H.), University of Alabama at Birmingham, Birmingham, Alabama
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for P.M. Foreman
H. Shallwani
cDepartment of Neurosurgery (H.S., A.H.S., E.I.L.), State University of New York at Buffalo, Buffalo, New York
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for H. Shallwani
R. Gupta
aFrom the Neurosurgical Service (N.A., J.M.M., M.W., C.J.G., R.G., A.A.D., R.M.-L., A.A., A.J.T., C.S.O.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for R. Gupta
A.A. Dmytriw
aFrom the Neurosurgical Service (N.A., J.M.M., M.W., C.J.G., R.G., A.A.D., R.M.-L., A.A., A.J.T., C.S.O.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for A.A. Dmytriw
R. Motiei-Langroudi
aFrom the Neurosurgical Service (N.A., J.M.M., M.W., C.J.G., R.G., A.A.D., R.M.-L., A.A., A.J.T., C.S.O.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for R. Motiei-Langroudi
A. Alturki
aFrom the Neurosurgical Service (N.A., J.M.M., M.W., C.J.G., R.G., A.A.D., R.M.-L., A.A., A.J.T., C.S.O.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for A. Alturki
M.R. Harrigan
bDepartment of Neurosurgery (P.M.F., M.R.H.), University of Alabama at Birmingham, Birmingham, Alabama
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for M.R. Harrigan
A.H. Siddiqui
cDepartment of Neurosurgery (H.S., A.H.S., E.I.L.), State University of New York at Buffalo, Buffalo, New York
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for A.H. Siddiqui
E.I. Levy
cDepartment of Neurosurgery (H.S., A.H.S., E.I.L.), State University of New York at Buffalo, Buffalo, New York
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for E.I. Levy
A.J. Thomas
aFrom the Neurosurgical Service (N.A., J.M.M., M.W., C.J.G., R.G., A.A.D., R.M.-L., A.A., A.J.T., C.S.O.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for A.J. Thomas
C.S. Ogilvy
aFrom the Neurosurgical Service (N.A., J.M.M., M.W., C.J.G., R.G., A.A.D., R.M.-L., A.A., A.J.T., C.S.O.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for C.S. Ogilvy
  • Article
  • Figures & Data
  • Supplemental
  • Info & Metrics
  • References
  • PDF
Loading

Article Figures & Data

Figures

  • Tables
  • FIGURE.
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIGURE.

    Age-related variation in the rate of complete occlusion following intracranial aneurysm treatment with PEDs.

Tables

  • Figures
    • View popup
    Table 1:

    Baseline characteristics

    ParameterNo.
    No. of procedures329
    No. of aneurysms380
    Sex
        Female272 (82.7%)
        Male57 (17.3%)
    Median age (range) (yr)58 (18–82)
    Smoking85 (25.8%)
    Multiple aneurysms148 (45%)
    Pretreatment mRS
        0–2314 (95.4%)
        3–515 (4.6%)
    Aneurysm location
        ICA
            Petrous7 (1.8%)
            Cavernous63 (16.6%)
            Paraophthalmic212 (55.8%)
            PcomA34 (9%)
        ACA/AcomA5 (1.3%)
        MCA8 (2.1%)
        Posterior circulation51 (13.4%)
    Aneurysm shape
        Saccular257 (67.6%)
        Blister11 (2.9%)
        Fusiform102 (26.9%)
        Dissecting10 (2.6%)
    Aneurysm measurements (median) (range) (mm)
        Maximal diametera7.7 (1–44.5)
        Neck size (for saccular aneurysms)b4 (1–15.6)
        Dome-to-neck ratio (for saccular aneurysms)b1.3 (0.4–3.5)
    Daughter sac94 (24.7%)
    Subarachnoid hemorrhage
        Acute (<2 wk)10 (3%)
        Remote (>2 wk)32 (9.7%)
    Prior treatment
        Endovascular33 (8.7%)
        Operation6 (1.6%)
        Both4 (1.1%)
    • Note:—ACA indicates anterior cerebral artery; PcomA, posterior communicating artery; AcomA, anterior communicating artery.

    • ↵a Data are missing for 11 aneurysms.

    • ↵b Data are missing for 41 aneurysms.

    • View popup
    Table 2:

    Outcome measures

    ParameterNo.
    No. of Pipelines
        1255 (77.5%)
        252 (15.8%)
        ≥322 (6.7%)
    Platelet function test
        Yes316 (96%)
        No13 (4%)
    Clopidogrel responder
        Yes228 (72.2%)
        No88 (27.8%)
    Nonresponders' treatment
        Switch to ticagrelor27 (30.7%)
        Clopidogrel boost39 (44.3%)
        Same dose of clopidogrel22 (25%)
    Last angiographic follow-up (median) (range) (mo)13.5 (1–83)
    Follow-up occlusion rate
        Complete (100%)297 (78.2%)
        Near-complete (90%–99%)29 (7.6%)
        Partial (<90%)54 (14.2%)
    Retreatment
        Endovascular24 (6.3%)
    Posttreatment mRS
        0–2314 (95.6%)
        3–511 (3.3%)
        6 (Death)4 (1.2%)
    Follow-up mRS
        Improved110 (33.4%)
        No change190 (57.8%)
        Worsened29 (8.8%)
    Neurologic complications
        Thromboembolic31 (9.4%)
            Symptomatic17 (5.2%)
        Hemorrhagic11 (3.3%)
            Symptomatic6 (1.8%)
    • View popup
    Table 3:

    Multivariable logistic regression for predictors of incomplete occlusion at last follow-up

    ParameterOR95% CIP Value
    Age (older than 70 yr)2.01.1–3.8.03
    Nonsmokers2.01.1–3.9.03
    PcomA/posterior circulation1.60.9–2.9.13
    Maximal diameter (≥21 mm)2.10.9–4.7.08
    Length of follow-up (<12 months)2.11.2–3.5.007
    • Note:—PcomA indicates posterior communicating artery.

PreviousNext
Back to top

In this issue

American Journal of Neuroradiology: 38 (12)
American Journal of Neuroradiology
Vol. 38, Issue 12
1 Dec 2017
  • Table of Contents
  • Index by author
  • Complete Issue (PDF)
Advertisement
Print
Download PDF
Email Article

Thank you for your interest in spreading the word on American Journal of Neuroradiology.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Predictors of Incomplete Occlusion following Pipeline Embolization of Intracranial Aneurysms: Is It Less Effective in Older Patients?
(Your Name) has sent you a message from American Journal of Neuroradiology
(Your Name) thought you would like to see the American Journal of Neuroradiology web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Predictors of Incomplete Occlusion following Pipeline Embolization of Intracranial Aneurysms: Is It Less Effective in Older Patients?
N. Adeeb, J.M. Moore, M. Wirtz, C.J. Griessenauer, P.M. Foreman, H. Shallwani, R. Gupta, A.A. Dmytriw, R. Motiei-Langroudi, A. Alturki, M.R. Harrigan, A.H. Siddiqui, E.I. Levy, A.J. Thomas, C.S. Ogilvy
American Journal of Neuroradiology Dec 2017, 38 (12) 2295-2300; DOI: 10.3174/ajnr.A5375

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Predictors of Incomplete Occlusion following Pipeline Embolization of Intracranial Aneurysms: Is It Less Effective in Older Patients?
N. Adeeb, J.M. Moore, M. Wirtz, C.J. Griessenauer, P.M. Foreman, H. Shallwani, R. Gupta, A.A. Dmytriw, R. Motiei-Langroudi, A. Alturki, M.R. Harrigan, A.H. Siddiqui, E.I. Levy, A.J. Thomas, C.S. Ogilvy
American Journal of Neuroradiology Dec 2017, 38 (12) 2295-2300; DOI: 10.3174/ajnr.A5375
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
Purchase

Jump to section

  • Article
    • Abstract
    • ABBREVIATION:
    • Materials and Methods
    • Results
    • Discussion
    • Conclusions
    • Footnotes
    • References
  • Figures & Data
  • Supplemental
  • Info & Metrics
  • References
  • PDF

Related Articles

  • PubMed
  • Google Scholar

Cited By...

  • Neck Location on the Outer Convexity is a Predictor of Incomplete Occlusion in Treatment with the Pipeline Embolization Device: Clinical and Angiographic Outcomes
  • Feasibility study for use of angiographic parametric imaging and deep neural networks for intracranial aneurysm occlusion prediction
  • The FRED for Cerebral Aneurysms of the Posterior Circulation: A Subgroup Analysis of the EuFRED Registry
  • Aneurysm Remnants after Flow Diversion: Clinical and Angiographic Outcomes
  • Acutely Ruptured Intracranial Aneurysms Treated with Flow-Diverter Stents: A Systematic Review and Meta-Analysis
  • European Multicenter Study for the Evaluation of a Dual-Layer Flow-Diverting Stent for Treatment of Wide-Neck Intracranial Aneurysms: The European Flow-Redirection Intraluminal Device Study
  • Crossref
  • Google Scholar

This article has not yet been cited by articles in journals that are participating in Crossref Cited-by Linking.

More in this TOC Section

  • Ruptured Intracranial Aneurysms Treated with the Pipeline Embolization Device: A Systematic Review and Pooled Analysis of Individual Patient Data
  • Postprocedural Antiplatelet Treatment after Emergent Carotid Stenting in Tandem Lesions Stroke: Impact on Stent Patency beyond Day 1
  • Fast Stent Retrieval during Mechanical Thrombectomy Improves Recanalization in Patients with the Negative Susceptibility Vessel Sign
Show more INTERVENTIONAL

Similar Articles

Advertisement

News and Updates

  • Lucien Levy Best Research Article Award
  • Thanks to our 2020 Distinguished Reviewers
  • Press Releases

Resources

  • Evidence-Based Medicine Level Guide
  • How to Participate in a Tweet Chat
  • AJNR Podcast Archive
  • Ideas for Publicizing Your Research
  • Librarian Resources
  • Terms and Conditions

Opportunities

  • Share Your Art in Perspectives
  • Get Peer Review Credit from Publons
  • Moderate a Tweet Chat

American Society of Neuroradiology

  • Neurographics
  • ASNR Annual Meeting
  • Fellowship Portal
  • Position Statements

© 2021 by the American Society of Neuroradiology | Print ISSN: 0195-6108 Online ISSN: 1936-959X

Powered by HighWire