PT  - JOURNAL ARTICLE
AU  - Kallmes, D.F.
AU  - Hanel, R.
AU  - Lopes, D.
AU  - Boccardi, E.
AU  - Bonafé, A.
AU  - Cekirge, S.
AU  - Fiorella, D.
AU  - Jabbour, P.
AU  - Levy, E.
AU  - McDougall, C.
AU  - Siddiqui, A.
AU  - Szikora, I.
AU  - Woo, H.
AU  - Albuquerque, F.
AU  - Bozorgchami, H.
AU  - Dashti, S.R.
AU  - Delgado Almandoz, J.E.
AU  - Kelly, M.E.
AU  - Turner, R.
AU  - Woodward, B.K.
AU  - Brinjikji, W.
AU  - Lanzino, G.
AU  - Lylyk, P.
TI  - International Retrospective Study of the Pipeline Embolization Device: A Multicenter Aneurysm Treatment Study
AID  - 10.3174/ajnr.A4111
DP  - 2015 Jan 01
TA  - American Journal of Neuroradiology
PG  - 108--115
VI  - 36
IP  - 1
4099  - http://www.ajnr.org/content/36/1/108.short
4100  - http://www.ajnr.org/content/36/1/108.full
SO  - Am. J. Neuroradiol.2015 Jan 01; 36
AB  - 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. IntrePEDInternational Retrospective Study of Pipeline Embolization DeviceIPHintraparenchymal hemorrhagePEDPipeline Embolization Device