TY - JOUR T1 - Treatment of Intracranial Aneurysms by Functional Reconstruction of the Parent Artery: The Budapest Experience with the Pipeline Embolization Device JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 1139 LP - 1147 DO - 10.3174/ajnr.A2023 VL - 31 IS - 6 AU - I. Szikora AU - Z. Berentei AU - Z. Kulcsar AU - M. Marosfoi AU - Z.S. Vajda AU - W. Lee AU - A. Berez AU - P.K. Nelson Y1 - 2010/06/01 UR - http://www.ajnr.org/content/31/6/1139.abstract N2 - 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. AICAanterior inferior cerebellar arteryBAbasilar arteryImmedImmediateDSAdigital subtraction angiographyICAinternal carotid arteryIDinternal diameterMRAMR angiographyN/Anot applicablePcomAposterior communicating arteryPEDPipeline Embolization DevicePITAPipeline Embolization Device for Intracranial Treatment of AneurysmsRecanrecanalizationSAHsubarachnoid hemorrhageSCAsuperior cerebellar arterySupsuperior ER -