RT Journal Article
SR Electronic
T1 International Retrospective Study of the Pipeline Embolization Device: A Multicenter Aneurysm Treatment Study
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 108
OP 115
DO 10.3174/ajnr.A4111
VO 36
IS 1
A1 Kallmes, D.F.
A1 Hanel, R.
A1 Lopes, D.
A1 Boccardi, E.
A1 Bonafé, A.
A1 Cekirge, S.
A1 Fiorella, D.
A1 Jabbour, P.
A1 Levy, E.
A1 McDougall, C.
A1 Siddiqui, A.
A1 Szikora, I.
A1 Woo, H.
A1 Albuquerque, F.
A1 Bozorgchami, H.
A1 Dashti, S.R.
A1 Delgado Almandoz, J.E.
A1 Kelly, M.E.
A1 Turner, R.
A1 Woodward, B.K.
A1 Brinjikji, W.
A1 Lanzino, G.
A1 Lylyk, P.
YR 2015
UL http://www.ajnr.org/content/36/1/108.abstract
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