Journal article
A2, M2, P2 aneurysms and beyond: results of treatment with pipeline embolization device in 65 patients
Journal of neurointerventional surgery, Vol.11(9), pp.903-907
01/23/2019
DOI: 10.1136/neurintsurg-2018-014631
PMID: 30674637
Abstract
Intracranial aneurysms located in the distal vessels are rare and remain a challenge to treat through surgical or endovascular interventions.
To describe a multicenter approach with flow diversion using the pipeline embolization device (PED) for treatment of distal intracranial aneurysms.
Cases of distal intracranial aneurysms defined as starting on or beyond the A2 anterior cerebral artery, M2 middle cerebral artery, and P2 posterior cerebral artery segments were included in the final analysis.
65 patients with distal aneurysms treated with the PED were analyzed. Median aneurysm size at the largest diameter was 7.0 mm, 60% were of a saccular morphology, and 9/65 (13.8%) patients presented in the setting of acute rupture. Angiographic follow-up data were available for 53 patients, with a median follow-up time of 6 months: 44/53 (83%) aneurysms showed complete obliteration, 7/53 (13.2%) showed reduced filling, and 2/53 (3%) showed persistent filling. There was no association between patient characteristics, including aneurysm size (P=0.36), parent vessel diameter (P=0.27), location (P=0.81), morphology (P=0.63), ruptured status on admission (P=0.57), or evidence of angiographic occlusion at the end of the embolization procedure (P=0.49). Clinical outcome data were available for 60/65 patients: 95% (57/60) had good clinical outcome (modified Rankin Scale score of 0-2) at 3 months.
This large multicenter study of patients with A2, M2, and P2 distal aneurysms treated with the PED showed that flow diversion may be an effective treatment approach for this rare type of vascular pathology. The procedural compilation rate of 7.7% indicates the need for further studies as the flow diversion technology constantly evolves.
Details
- Title: Subtitle
- A2, M2, P2 aneurysms and beyond: results of treatment with pipeline embolization device in 65 patients
- Creators
- Christopher T Primiani - Department of Neurosurgery, University of South Florida, Tampa, Florida, USAZeguang Ren - Department of Neurosurgery, University of South Florida, Tampa, Florida, USAPeter Kan - Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USARicardo Hanel - Department of Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USAVitor Mendes Pereira - Division of Neuroradiology, University Health Network - Toronto Western Hospital, Toronto, Ontario, CanadaWai Man Lui - Division of Neurosurgery, Department of Surgery, The University of Hong Kong, Hong Kong, Hong KongNitin Goyal - Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USALucas Elijovich - Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USAAdam S Arthur - Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USADavid M Hasan - Department of Neurosurgery, University of Iowa, Iowa City, Iowa, USASantiago Ortega-Gutierrez - Department of Neurology, University of Iowa, Iowa City, Iowa, USAEdgar A Samaniego - Department of Neurology, University of Iowa, Iowa City, Iowa, USAAjit S Puri - Department of Radiology, University of Massachusetts, Worcester, Massachusetts, USAAnna L Kuhn - Department of Neurosurgery, Meshalkin National Medical Research Center, Novosibirsk, RussiaKirill Orlov - Department of Neurosurgery, Meshalkin National Medical Research Center, Novosibirsk, RussiaDmitry Kislitsin - Department of Neurosurgery, Meshalkin National Medical Research Center, Novosibirsk, RussiaAnton Gorbatykh - Department of Neurosurgery, Meshalkin National Medical Research Center, Novosibirsk, RussiaMuhammad Waqas - Department of Neurosurgery, University at Buffalo, Buffalo, New York, USAElad I Levy - Department of Neurosurgery, University at Buffalo, Buffalo, New York, USAAdnan H Siddiqui - Department of Neurosurgery, University at Buffalo, Buffalo, New York, USAMaxim Mokin - Department of Neurosurgery, University of South Florida, Tampa, Florida, USA
- Resource Type
- Journal article
- Publication Details
- Journal of neurointerventional surgery, Vol.11(9), pp.903-907
- Publisher
- England
- DOI
- 10.1136/neurintsurg-2018-014631
- PMID
- 30674637
- ISSN
- 1759-8478
- eISSN
- 1759-8486
- Language
- English
- Date published
- 01/23/2019
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
- Record Identifier
- 9984040262802771
Metrics
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