A single pipeline embolization device is sufficient for treatment of intracranial aneurysms

N Chalouhi; S Tjoumakaris; J L H Phillips; R M Starke; D Hasan; C Wu; M Zanaty; D Kung; L F Gonzalez; R Rosenwasser; P Jabbour

doi:10.3174/ajnr.A3957

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A single pipeline embolization device is sufficient for treatment of intracranial aneurysms

Journal article

Open access

Peer reviewed

A single pipeline embolization device is sufficient for treatment of intracranial aneurysms

N Chalouhi, S Tjoumakaris, J L H Phillips, R M Starke, D Hasan, C Wu, M Zanaty, D Kung, L F Gonzalez, R Rosenwasser, …

American journal of neuroradiology : AJNR, Vol.35(8), pp.1562-1566

08/2014

DOI: 10.3174/ajnr.A3957

PMID: 24788125

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Abstract

The Pipeline Embolization Device has emerged as an important treatment option for intracranial aneurysms. The number of devices needed to treat an aneurysm is uncertain and is the subject of vigorous debate. The purpose of this study was to compare rates of complications, aneurysm occlusion, and outcome in patients treated with a single-versus-multiple Pipeline Embolization Devices. One hundred seventy-eight patients were treated with the Pipeline Embolization Device at our institution. Patients were divided into 2 groups: a single-device group (n = 126) and a multiple-device group (n = 52). There was no statistically significant difference between the 2 groups with respect to baseline characteristics except for age and aneurysm size (higher with multiple Pipeline Embolization Devices). Complications occurred more frequently with multiple (15%) versus a single device (5%, P = .03). In multivariate analysis, the use of multiple devices independently predicted complications. A similar proportion of patients achieved adequate aneurysm obliteration at follow-up in the single-device (84%) and the multiple-device groups (87%, P = .8). In multivariate analysis, age and follow-up time predicted obliteration. At follow-up, a significantly higher proportion of patients treated with a single device (97%) achieved a favorable outcome compared with those treated with multiple devices (89%, P = .03). In multivariate analysis, there was a strong trend for the use of a single device to predict favorable outcomes (P = .06). Treatment with a single Pipeline Embolization Device provides similar occlusion rates with less complications and better overall outcomes. These findings suggest that a single Pipeline Embolization Device is sufficient for treatment of most intracranial aneurysms.

Embolization, Therapeutic - instrumentation

Multivariate Analysis

Intracranial Aneurysm - therapy

Humans

Middle Aged

Adult

Female

Male

Treatment Outcome

Embolization, Therapeutic - adverse effects

Details

Title: Subtitle: A single pipeline embolization device is sufficient for treatment of intracranial aneurysms
Creators: N Chalouhi - From the Department of Neurosurgery (N.C., S.T., J.L.H.P., R.M.S., C.W., M.Z., D.K., L.F.G., R.R., P.J.), Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania
S Tjoumakaris - From the Department of Neurosurgery (N.C., S.T., J.L.H.P., R.M.S., C.W., M.Z., D.K., L.F.G., R.R., P.J.), Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania
J L H Phillips - From the Department of Neurosurgery (N.C., S.T., J.L.H.P., R.M.S., C.W., M.Z., D.K., L.F.G., R.R., P.J.), Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania
R M Starke - From the Department of Neurosurgery (N.C., S.T., J.L.H.P., R.M.S., C.W., M.Z., D.K., L.F.G., R.R., P.J.), Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania
D Hasan - Department of Neurosurgery (D.H.), University of Iowa, Iowa City, Iowa
C Wu - From the Department of Neurosurgery (N.C., S.T., J.L.H.P., R.M.S., C.W., M.Z., D.K., L.F.G., R.R., P.J.), Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania
M Zanaty - From the Department of Neurosurgery (N.C., S.T., J.L.H.P., R.M.S., C.W., M.Z., D.K., L.F.G., R.R., P.J.), Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania
D Kung - From the Department of Neurosurgery (N.C., S.T., J.L.H.P., R.M.S., C.W., M.Z., D.K., L.F.G., R.R., P.J.), Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania
L F Gonzalez - From the Department of Neurosurgery (N.C., S.T., J.L.H.P., R.M.S., C.W., M.Z., D.K., L.F.G., R.R., P.J.), Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania
R Rosenwasser - From the Department of Neurosurgery (N.C., S.T., J.L.H.P., R.M.S., C.W., M.Z., D.K., L.F.G., R.R., P.J.), Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania
P Jabbour - From the Department of Neurosurgery (N.C., S.T., J.L.H.P., R.M.S., C.W., M.Z., D.K., L.F.G., R.R., P.J.), Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania pascal.jabbour@jefferson.edu
Resource Type: Journal article
Publication Details: American journal of neuroradiology : AJNR, Vol.35(8), pp.1562-1566
DOI: 10.3174/ajnr.A3957
PMID: 24788125
NLM abbreviation: AJNR Am J Neuroradiol
ISSN: 0195-6108
eISSN: 1936-959X
Publisher: United States
Language: English
Date published: 08/2014
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
Record Identifier: 9984040000602771

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