E-056 Pipeline Endovascular Device for the Treatment of Intracranial Aneurysm at the Level of the Circle of Willis and Beyond: Multicenter Experience

    loading  Checking for direct PDF access through Ovid

Abstract

Background and purpose

The aim of our study was to evaluate the safety and eficacy of the Pipeline endovascular device for the treatment of anterior circulation aneurysms at the level of circle of Willis and beyond.

Methods

A consecutive series of 23 patients with unruptured and 1 with ruptured anterior circulation aneurysms treated with Pipeline endovascular device. Complication rates, aneurysm obliteration, modified Rankin Scale (mRS) outcomes were assessed.

Results

All devices were placed properly, without technical difficulties.

Results

We found 1 minor clinical event (resolved within 7 days from procedure) and 1 major event (symptoms present after 7 days) (table), and no mortality.

Results

There were no aneurysm rupture or parenchymal haemorrhage during follow-up.

Results

The mRS at 3 and 6 months did not change from prior mRS in all cases but 1.

Results

We had 2 asymptomatic periprocedural ischemic events: 1 perforator stroke in the case of a recanalised A1-A2 where we used 2 PEDs, and 1 lacunar stroke. Both cases were discovered incidentally at the control CT predischarge.

Results

We had 3 intraprocedural complications, resolved without clinical consequences:1 acute branch occlusion during hypotension state which was solved after TA raise (case 4), 1 slow opacification of the inferior trunk of MCA resolved with intraarterial bolus of reopro (case 20), and 1 focal SAH secondary to distal perforation with the microwire during and exchange manoeuvre which was resolved with coil occlusion and glue at the level of the perforation, with no symptoms (case 14)

Results

Six-month follow-up angiograms were obtained in 16 aneurysms, showing complete occlusion in 9 and significantly decreased residual filling in 7.

Results

5 cases are still pending on 6 months DSA and 1 case showed residual filling at the 3 months follow-up.

Results

Patency of PEDs and status of branches originating from the aneurysm sacs were evaluated in 17 and 11 angiograms respectively.

Results

All PEDs were patent, but we found 4 intrastent stenosis at 6 months DSA where only 1 symptomatic case (an angioplasty was done successfully).

Results

In the 11 branches evaluated, 7 were patent, 2 moderate reduced and in 2 cases were occluded asymptomatically.

Conclusion

The PED provides a safe and effective solution for aneurysms at and beyond the circle of Willis. Preliminary results are promising but larger series with longer-term follow-up examinations are required to show the long-term safety and durability of this treatment alternative.

Disclosures

M. Martínez-Galdámez: 2; C; Covidien. I. Linfante: 2; C; Covidien, Stryker, Codman. E. Lin: None. G. Dabus: 2; C; Covidien, Microvention, Reverse Medical.

Related Topics

    loading  Loading Related Articles