The Role of the Pipeline Embolization Device for the Treatment of Dissecting Intracranial Aneurysms
Abstract
SUMMARY: Intracranial dissecting aneurysms constitute rare lesions with complex management and elevated morbidity and mortality. Results of 23 patients harboring such lesions treated with the PED are reported. Standard dual antiplatelet therapy was instituted. Neurologic and angiographic assessments were obtained at 3, 6, and 12 months. Clinical presentation included SAH (52%), symptoms of mass effect (22%), ischemia (4%), and incidental finding (22%). The posterior circulation was affected in 91% of cases. Total occlusion was demonstrated in 69.5% of patients, with an increment to 87.5% considering only patients with at least 3 months of follow-up. Small aneurysms demonstrated higher rates of total occlusion (6/7) compared with large (5/7) and giant (5/9) ones. Good clinical outcome was achieved in 74% of patients. Reconstructive endovascular treatment of intracranial dissecting aneurysms with the PED provided good clinical and angiographic results with acceptable risks, representing an attractive therapeutic option for this complex disease, especially when parent vessel preservation is mandatory.
ABBREVIATIONS
- DSA
- digital subtraction angiography
- GOS
- Glasgow Outcome Score
- ICA
- internal carotid artery
- PED
- Pipeline Embolization Device
- PICA
- posterior inferior cerebellar artery
- SAH
- subarachnoid hemorrhage
- © 2011 by American Journal of Neuroradiology
In this issue
Jump to section
Related Articles
Cited By...
- Flow diverters in the treatment of intracranial dissecting aneurysms: a systematic review and meta-analysis of safety and efficacy
- Ruptured Intracranial Aneurysms Treated with the Pipeline Embolization Device: A Systematic Review and Pooled Analysis of Individual Patient Data
- Antiplatelet therapy and the risk of ischemic and hemorrhagic complications associated with Pipeline embolization of cerebral aneurysms: a systematic review and pooled analysis
- Acutely Ruptured Intracranial Aneurysms Treated with Flow-Diverter Stents: A Systematic Review and Meta-Analysis
- Flow diverter treatment of intracranial vertebral artery dissecting pseudoaneurysms
- Ophthalmic artery occlusion after Pipeline Embolization Device placement with reconstitution of flow via an endoleak: a report of two cases
- Treatment of posterior circulation non-saccular aneurysms with flow diverters: a single-center experience and review of 56 patients
- Endovascular reconstruction of unruptured intradural vertebral artery dissecting aneurysms with the Pipeline embolization device
- Current Trends and Results of Endovascular Treatment of Unruptured Intracranial Aneurysms at a Single Institution in the Flow-Diverter Era
- Effect of antiplatelet therapy and platelet function testing on hemorrhagic and thrombotic complications in patients with cerebral aneurysms treated with the pipeline embolization device: a review and meta-analysis
- Utilization of Pipeline embolization device for treatment of ruptured intracranial aneurysms: US multicenter experience
- Endovascular treatment of acute intracranial vertebral artery dissection: long-term follow-up results of internal trapping and reconstructive treatment using coils and stents
- A reappraisal of the Pipeline embolization device for the treatment of posterior circulation aneurysms
- Primary endovascular treatment of post-irradiated carotid pseudoaneurysm at the skull base with the Pipeline embolization device
- Treatment of a dissecting vertebral artery aneurysm with angioplasty and the pipeline embolisation device
- Pipeline Embolization Device as primary treatment for blister aneurysms and iatrogenic pseudoaneurysms of the internal carotid artery
- International Retrospective Study of the Pipeline Embolization Device: A Multicenter Aneurysm Treatment Study
- Pipeline endovascular reconstruction of traumatic dissecting aneurysms of the intracranial internal carotid artery
- Pipeline endovascular reconstruction of traumatic dissecting aneurysms of the intracranial internal carotid artery
- Reconstructive endovascular treatment of a ruptured vertebral artery dissecting aneurysm using the Pipeline embolization device
- Using Leo Plus stent as flow diverter and endoluminal remodeling in endovascular treatment of intracranial fusiform aneurysms
- Endovascular treatment of fusiform intracranial aneurysms
- Stent usage in the treatment of intracranial aneurysms: past, present and future
- Pipeline Embolization Device in Aneurysmal Subarachnoid Hemorrhage
- Endovascular Treatment of Intracranial Aneurysms With Flow Diverters: A Meta-Analysis
- What's Coming Down the Pipe--And Should We Be Excited, Concerned, or Both?
- Long-Term Clinical and Imaging Follow-Up of Complex Intracranial Aneurysms Treated by Endovascular Parent Vessel Occlusion
- Safety of the Pipeline Embolization Device in Treatment of Posterior Circulation Aneurysms
This article has been cited by the following articles in journals that are participating in Crossref Cited-by Linking.
- Waleed Brinjikji, Mohammad H. Murad, Giuseppe Lanzino, Harry J. Cloft, David F. KallmesStroke 2013 44 2
- D. F. Kallmes, R. Hanel, D. Lopes, E. Boccardi, A. Bonafe, S. Cekirge, D. Fiorella, P. Jabbour, E. Levy, C. McDougall, A. Siddiqui, I. Szikora, H. Woo, F. Albuquerque, H. Bozorgchami, S. R. Dashti, J. E. Delgado Almandoz, M. E. Kelly, R. Turner, B. K. Woodward, W. Brinjikji, G. Lanzino, P. LylykAmerican Journal of Neuroradiology 2015 36 1
- Francesco Briganti, Giuseppe Leone, Mariano Marseglia, Giuseppe Mariniello, Ferdinando Caranci, Arturo Brunetti, Francesco MaiuriThe Neuroradiology Journal 2015 28 4
- T.J. Phillips, J.D. Wenderoth, C.C. Phatouros, H. Rice, T.P. Singh, L. Devilliers, V. Wycoco, S. Meckel, W. McAuliffeAmerican Journal of Neuroradiology 2012 33 7
- Tibor Becske, Matthew B. Potts, Maksim Shapiro, David F. Kallmes, Waleed Brinjikji, Isil Saatci, Cameron G. McDougall, István Szikora, Giuseppe Lanzino, Christopher J. Moran, Henry H. Woo, Demetrius K. Lopes, Aaron L. Berez, Daniel J. Cher, Adnan H. Siddiqui, Elad I. Levy, Felipe C. Albuquerque, David J. Fiorella, Zsolt Berentei, Miklós Marosföi, Saruhan H. Cekirge, Peter K. NelsonJournal of Neurosurgery 2017 127 1
- Purvee D. Patel, Nohra Chalouhi, Elias Atallah, Stavropoula Tjoumakaris, David Hasan, Hekmat Zarzour, Robert Rosenwasser, Pascal JabbourNeurosurgical Focus 2017 42 6
- Ning Lin, Adam M Brouillard, Kiffon M Keigher, Demetrius K Lopes, Mandy J Binning, Kenneth M Liebman, Erol Veznedaroglu, Jordan A Magarik, J Mocco, Edward A Duckworth, Adam S Arthur, Andrew J Ringer, Kenneth V Snyder, Elad I Levy, Adnan H SiddiquiJournal of NeuroInterventional Surgery 2015 7 11
- F. Cagnazzo, D.T. di Carlo, M. Cappucci, P.-H. Lefevre, V. Costalat, P. PerriniAmerican Journal of Neuroradiology 2018 39 9
- Ning Lin, Adam M. Brouillard, Chandan Krishna, Maxim Mokin, Sabareesh K. Natarajan, Ashish Sonig, Kenneth V. Snyder, Elad I. Levy, Adnan H. SiddiquiNeurosurgery 2015 76 2
- G. K. K. Leung, A. C. O. Tsang, W. M. LuiClinical Neuroradiology 2012 22 4