TY - JOUR T1 - International Retrospective Study of the Pipeline Embolization Device: A Multicenter Aneurysm Treatment Study JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. DO - 10.3174/ajnr.A4111 AU - D.F. Kallmes AU - R. Hanel AU - D. Lopes AU - E. Boccardi AU - A. Bonafé AU - S. Cekirge AU - D. Fiorella AU - P. Jabbour AU - E. Levy AU - C. McDougall AU - A. Siddiqui AU - I. Szikora AU - H. Woo AU - F. Albuquerque AU - H. Bozorgchami AU - S.R. Dashti AU - J.E. Delgado Almandoz AU - M.E. Kelly AU - R. Turner IV AU - B.K. Woodward AU - W. Brinjikji AU - G. Lanzino AU - P. Lylyk Y1 - 2014/12/11 UR - http://www.ajnr.org/content/early/2014/12/11/ajnr.A4111.abstract N2 - BACKGROUND AND PURPOSE: Flow diverters are increasingly used in the endovascular treatment of intracranial aneurysms. Our aim was to determine neurologic complication rates following Pipeline Embolization Device placement for intracranial aneurysm treatment in a real-world setting. MATERIALS AND METHODS: We retrospectively evaluated all patients with intracranial aneurysms treated with the Pipeline Embolization Device between July 2008 and February 2013 in 17 centers worldwide. We defined 4 subgroups: internal carotid artery aneurysms of ≥10 mm, ICA aneurysms of <10 mm, other anterior circulation aneurysms, and posterior circulation aneurysms. Neurologic complications included spontaneous rupture, intracranial hemorrhage, ischemic stroke, permanent cranial neuropathy, and mortality. Comparisons were made with t tests or ANOVAs for continuous variables and the Pearson χ2 or Fisher exact test for categoric variables. RESULTS: In total, 793 patients with 906 aneurysms were included. The neurologic morbidity and mortality rate was 8.4% (67/793), highest in the posterior circulation group (16.4%, 9/55) and lowest in the ICA <10-mm group (4.8%, 14/294) (P = .01). The spontaneous rupture rate was 0.6% (5/793). The intracranial hemorrhage rate was 2.4% (19/793). Ischemic stroke rates were 4.7% (37/793), highest in patients with posterior circulation aneurysms (7.3%, 4/55) and lowest in the ICA <10-mm group (2.7%, 8/294) (P = .16). Neurologic mortality was 3.8% (30/793), highest in the posterior circulation group (10.9%, 6/55) and lowest in the anterior circulation ICA <10-mm group (1.4%, 4/294) (P < .01). CONCLUSIONS: Aneurysm treatment with the Pipeline Embolization Device is associated with the lowest complication rates when used to treat small ICA aneurysms. Procedure-related morbidity and mortality are higher in the treatment of posterior circulation and giant aneurysms. Abbreviations IntrePEDInternational Retrospective Study of Pipeline Embolization DeviceIPHintraparenchymal hemorrhagePEDPipeline Embolization Device ER -