Immediate and Midterm Results following Treatment of Recently Ruptured Intracranial Aneurysms with the Pipeline Embolization Device

BACKGROUND AND PURPOSE: A number of flow-diverting devices have become available for endovascular occlusion of cerebral aneurysms. This article reports immediate and midterm results in recently ruptured aneurysms treated with the PED.

MATERIALS AND METHODS: A prospective registry was established at 3 Australian neurointerventional sites to collect data on ruptured and unruptured aneurysms treated with PED during a 12-month period from August 2009. From this data base of 65 patients, 11 cases of recent aneurysmal SAH were examined. Relevant data including antiplatelet therapy, technical issues, complications, and imaging findings during at least a 6-month period of follow-up were collected and analyzed.

RESULTS: Eleven patients had acutely ruptured aneurysms with SAH. Clinical follow-up was available on all cases with imaging follow-up at 6 months in 9 patients. Two patients died from rebleeding during the acute illness. There was no other procedural or delayed significant symptomatic morbidity. Eight aneurysms were occluded with a single case of residual body filling.

CONCLUSIONS: PED should be used in SAH with caution, reserved for suitable patients concomitantly treated with endosaccular coiling if possible.