TY - JOUR T1 - Ruptured Intracranial Aneurysms Treated with the Pipeline Embolization Device: A Systematic Review and Pooled Analysis of Individual Patient Data JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. DO - 10.3174/ajnr.A7002 AU - P.M. Foreman AU - A. Ilyas AU - M.C. Cress AU - J.A. Vachhani AU - R.A. Hirschl AU - B. Agee AU - C.J. Griessenauer Y1 - 2021/02/18 UR - http://www.ajnr.org/content/early/2021/02/18/ajnr.A7002.abstract N2 - BACKGROUND: The Pipeline Embolization Device (PED) is a flow-diverting stent for the treatment of intracranial aneurysms and is used off-label for a subset of ruptured aneurysms not amenable to traditional treatment.PURPOSE: Our aim was to evaluate the safety and efficacy of the PED for treatment of ruptured intracranial aneurysms.DATA SOURCES: A systematic review of the MEDLINE, EMBASE, and Scopus data bases from January 2011 to March 2020 was performed for articles reporting treatment of ruptured intracranial aneurysms with the PED.STUDY SELECTION: A total of 12 studies comprising 145 patients with 145 treated aneurysms were included for analysis.DATA ANALYSIS: Individual patient data were collected. Nonparametric tests were used to compare differences among patients. Logistic regression was used to determine an association with outcome variables.DATA SYNTHESIS: Mean aneurysm size was 5.9 mm, and most were blister (51.0%) or dissecting (26.9%) in morphology. Three (2.1%) aneurysms reruptured following PED placement. Univariate logistic regression identified larger aneurysm size as a significant predictor of aneurysm rerupture (P = .008). Of patients with radiographic follow-up, 87.5% had complete aneurysm occlusion. Symptomatic neurologic complications occurred in 16.5%.LIMITATIONS: Analysis was limited by the quality of the included data, most of which were from small case series representing class III medical evidence. No study assessed outcome in a blinded or independently adjudicated manner.CONCLUSIONS: Most ruptured aneurysms treated with the PED were blister or dissecting aneurysms. Treatment was associated with a rerupture rate of 2.1% and a complete occlusion rate of 87.5%.DAPTdual-antiplatelet therapyPEDPipeline Embolization Device ER -