Treatment of distal anterior circulation aneurysms with the pipeline embolization device

A US multicenter experience

Ning Lin, Giuseppe Lanzino, Demetrius K. Lopes, Adam Arthur, Christopher S. Ogilvy, Robert D. Ecker, Travis M. Dumont, Raymond D. Turner, M. Reid Gooch, Alan S. Boulos, Peter Kan, Kenneth V. Snyder, Elad I. Levy, Adnan H. Siddiqui

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

BACKGROUND: Utilization of the Pipeline embolization device (PED) to treat distal carotid circulation aneurysms has not been well studied. OBJECTIVE: To report the collective experience of using PED to treat distal anterior circulation aneurysms. METHODS: We retrospectively reviewed clinical and radiographic records of all patients who underwent Pipeline embolization of distal anterior circulation aneurysms at 10 US neurosurgical centers between 2011 and 2013. RESULTS: Twenty-eight patients (mean age 51.7 years; 18 women) with 28 aneurysms were included in the analyses. Fifteen aneurysms were fusiform, 5 dissecting, and 8 saccular. Average aneurysm size was 12.3 mm; 7 were giant. Twenty aneurysms were located along the middle cerebral artery, 6 along the anterior cerebral artery, and 2 along the anterior communicating artery. PED deployment was successful in 27 patients, with coils utilized in 6 cases. Clinical follow-up was available for an average of 10.7 months (range 3-26). Twenty-seven patients had follow-up neurovascular imaging: 21 aneurysms had complete occlusion, 4 had residual neck filling, and 2 had residual dome filling. Periprocedural complications (<30 days) occurred in 3 patients (10.7%), including 1 case of device failure resulting in stroke. Outcomes were good (modified Rankin Scale score 0 to 2) in 27 patients (96.4%) and fair (modified Rankin Scale 3) in 1. CONCLUSION: PED can be utilized in the treatment of distal anterior circulation aneurysms with difficult anatomy for conventional surgical or endovascular techniques. Larger-scale studies with long-term follow-up are needed to further elucidate the durability of PED treatment and its effect on perforator-rich vascular segments.

Original languageEnglish (US)
Pages (from-to)14-22
Number of pages9
JournalNeurosurgery
Volume79
Issue number1
DOIs
StatePublished - Jul 1 2016

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Aneurysm
Equipment and Supplies
Therapeutics
Equipment Failure
Anterior Cerebral Artery
Endovascular Procedures
Middle Cerebral Artery
Blood Vessels
Anatomy
Neck
Arteries
Stroke

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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Treatment of distal anterior circulation aneurysms with the pipeline embolization device : A US multicenter experience. / Lin, Ning; Lanzino, Giuseppe; Lopes, Demetrius K.; Arthur, Adam; Ogilvy, Christopher S.; Ecker, Robert D.; Dumont, Travis M.; Turner, Raymond D.; Gooch, M. Reid; Boulos, Alan S.; Kan, Peter; Snyder, Kenneth V.; Levy, Elad I.; Siddiqui, Adnan H.

In: Neurosurgery, Vol. 79, No. 1, 01.07.2016, p. 14-22.

Research output: Contribution to journalArticle

Lin, N, Lanzino, G, Lopes, DK, Arthur, A, Ogilvy, CS, Ecker, RD, Dumont, TM, Turner, RD, Gooch, MR, Boulos, AS, Kan, P, Snyder, KV, Levy, EI & Siddiqui, AH 2016, 'Treatment of distal anterior circulation aneurysms with the pipeline embolization device: A US multicenter experience', Neurosurgery, vol. 79, no. 1, pp. 14-22. https://doi.org/10.1227/NEU.0000000000001117
Lin, Ning ; Lanzino, Giuseppe ; Lopes, Demetrius K. ; Arthur, Adam ; Ogilvy, Christopher S. ; Ecker, Robert D. ; Dumont, Travis M. ; Turner, Raymond D. ; Gooch, M. Reid ; Boulos, Alan S. ; Kan, Peter ; Snyder, Kenneth V. ; Levy, Elad I. ; Siddiqui, Adnan H. / Treatment of distal anterior circulation aneurysms with the pipeline embolization device : A US multicenter experience. In: Neurosurgery. 2016 ; Vol. 79, No. 1. pp. 14-22.
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abstract = "BACKGROUND: Utilization of the Pipeline embolization device (PED) to treat distal carotid circulation aneurysms has not been well studied. OBJECTIVE: To report the collective experience of using PED to treat distal anterior circulation aneurysms. METHODS: We retrospectively reviewed clinical and radiographic records of all patients who underwent Pipeline embolization of distal anterior circulation aneurysms at 10 US neurosurgical centers between 2011 and 2013. RESULTS: Twenty-eight patients (mean age 51.7 years; 18 women) with 28 aneurysms were included in the analyses. Fifteen aneurysms were fusiform, 5 dissecting, and 8 saccular. Average aneurysm size was 12.3 mm; 7 were giant. Twenty aneurysms were located along the middle cerebral artery, 6 along the anterior cerebral artery, and 2 along the anterior communicating artery. PED deployment was successful in 27 patients, with coils utilized in 6 cases. Clinical follow-up was available for an average of 10.7 months (range 3-26). Twenty-seven patients had follow-up neurovascular imaging: 21 aneurysms had complete occlusion, 4 had residual neck filling, and 2 had residual dome filling. Periprocedural complications (<30 days) occurred in 3 patients (10.7{\%}), including 1 case of device failure resulting in stroke. Outcomes were good (modified Rankin Scale score 0 to 2) in 27 patients (96.4{\%}) and fair (modified Rankin Scale 3) in 1. CONCLUSION: PED can be utilized in the treatment of distal anterior circulation aneurysms with difficult anatomy for conventional surgical or endovascular techniques. Larger-scale studies with long-term follow-up are needed to further elucidate the durability of PED treatment and its effect on perforator-rich vascular segments.",
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AU - Lin, Ning

AU - Lanzino, Giuseppe

AU - Lopes, Demetrius K.

AU - Arthur, Adam

AU - Ogilvy, Christopher S.

AU - Ecker, Robert D.

AU - Dumont, Travis M.

AU - Turner, Raymond D.

AU - Gooch, M. Reid

AU - Boulos, Alan S.

AU - Kan, Peter

AU - Snyder, Kenneth V.

AU - Levy, Elad I.

AU - Siddiqui, Adnan H.

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N2 - BACKGROUND: Utilization of the Pipeline embolization device (PED) to treat distal carotid circulation aneurysms has not been well studied. OBJECTIVE: To report the collective experience of using PED to treat distal anterior circulation aneurysms. METHODS: We retrospectively reviewed clinical and radiographic records of all patients who underwent Pipeline embolization of distal anterior circulation aneurysms at 10 US neurosurgical centers between 2011 and 2013. RESULTS: Twenty-eight patients (mean age 51.7 years; 18 women) with 28 aneurysms were included in the analyses. Fifteen aneurysms were fusiform, 5 dissecting, and 8 saccular. Average aneurysm size was 12.3 mm; 7 were giant. Twenty aneurysms were located along the middle cerebral artery, 6 along the anterior cerebral artery, and 2 along the anterior communicating artery. PED deployment was successful in 27 patients, with coils utilized in 6 cases. Clinical follow-up was available for an average of 10.7 months (range 3-26). Twenty-seven patients had follow-up neurovascular imaging: 21 aneurysms had complete occlusion, 4 had residual neck filling, and 2 had residual dome filling. Periprocedural complications (<30 days) occurred in 3 patients (10.7%), including 1 case of device failure resulting in stroke. Outcomes were good (modified Rankin Scale score 0 to 2) in 27 patients (96.4%) and fair (modified Rankin Scale 3) in 1. CONCLUSION: PED can be utilized in the treatment of distal anterior circulation aneurysms with difficult anatomy for conventional surgical or endovascular techniques. Larger-scale studies with long-term follow-up are needed to further elucidate the durability of PED treatment and its effect on perforator-rich vascular segments.

AB - BACKGROUND: Utilization of the Pipeline embolization device (PED) to treat distal carotid circulation aneurysms has not been well studied. OBJECTIVE: To report the collective experience of using PED to treat distal anterior circulation aneurysms. METHODS: We retrospectively reviewed clinical and radiographic records of all patients who underwent Pipeline embolization of distal anterior circulation aneurysms at 10 US neurosurgical centers between 2011 and 2013. RESULTS: Twenty-eight patients (mean age 51.7 years; 18 women) with 28 aneurysms were included in the analyses. Fifteen aneurysms were fusiform, 5 dissecting, and 8 saccular. Average aneurysm size was 12.3 mm; 7 were giant. Twenty aneurysms were located along the middle cerebral artery, 6 along the anterior cerebral artery, and 2 along the anterior communicating artery. PED deployment was successful in 27 patients, with coils utilized in 6 cases. Clinical follow-up was available for an average of 10.7 months (range 3-26). Twenty-seven patients had follow-up neurovascular imaging: 21 aneurysms had complete occlusion, 4 had residual neck filling, and 2 had residual dome filling. Periprocedural complications (<30 days) occurred in 3 patients (10.7%), including 1 case of device failure resulting in stroke. Outcomes were good (modified Rankin Scale score 0 to 2) in 27 patients (96.4%) and fair (modified Rankin Scale 3) in 1. CONCLUSION: PED can be utilized in the treatment of distal anterior circulation aneurysms with difficult anatomy for conventional surgical or endovascular techniques. Larger-scale studies with long-term follow-up are needed to further elucidate the durability of PED treatment and its effect on perforator-rich vascular segments.

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