Endovascular treatment of intracranial aneurysms using the Pipeline Flex embolization device: a case series of 30 consecutive patients

M Martínez-Galdámez; S Pérez; A Vega; P Ruiz; J L Caniego; E Bárcena; P Saura; J C Méndez; F Delgado; S Ortega-Gutierrez; A Romance; T Diaz; E Gonzalez; A Gil; E Murias; P Vega

doi:10.1136/neurintsurg-2015-011669

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Endovascular treatment of intracranial aneurysms using the Pipeline Flex embolization device: a case series of 30 consecutive patients

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Endovascular treatment of intracranial aneurysms using the Pipeline Flex embolization device: a case series of 30 consecutive patients

M Martínez-Galdámez, S Pérez, A Vega, P Ruiz, J L Caniego, E Bárcena, P Saura, J C Méndez, F Delgado, S Ortega-Gutierrez, …

Journal of neurointerventional surgery, Vol.8(4), pp.396-401

04/2016

DOI: 10.1136/neurintsurg-2015-011669

PMID: 25770120

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Abstract

BackgroundThe Pipeline Flex embolization device has some peculiarities in comparison with the previous generation device. Despite recent reports of the modified delivery system, its safety is still unknown.ObjectiveTo illustrate the intraprocedural and periprocedural complication rate with this new device in 30 consecutive patients.Material and methodsClinical, procedural, and angiographic data, including aneurysm size and location, device or devices used, angiographic and clinical data were analyzed.Results30 patients harboring 30 aneurysms were analyzed. 39 devices were placed properly. Multiple Pipeline embolization devices (PEDs) were used in 7 cases. In 28 devices the distal end opened fully from the beginning with a complete wall apposition. In the remaining 11 devices, distal-end opening of the devices was instant but partial, but fully opened easily after recapture. Among the 30 procedures, recapture and reposition of the Pipeline Flex was performed four times owing to proximal migration/malposition of the device during delivery. Four intraprocedural/periprocedural complications occurred, of which 2 resulted in major complications, with neurologic deficits persisting for longer than 7 days. The 30-day morbidity rate was 6.6%, with no deaths. No aneurysm rupture or parenchymal hemorrhage was seen.ConclusionsThe Pipeline Flex embolization device allows more precise and controlled deployment than the first-generation device. The number of devices and the complication rate during the learning curve are lower than reported with the first-generation PED. The new delivery system and the resheathing maneuvers do not seem to increase the intraprocedural complication rate in comparison with the first-generation PED.

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Title: Subtitle: Endovascular treatment of intracranial aneurysms using the Pipeline Flex embolization device: a case series of 30 consecutive patients
Creators: M Martínez-Galdámez - Interventional Neuroradiology/Endovascular Neurosurgery, Radiology Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
S Pérez - Interventional Neuroradiology/Endovascular Neurosurgery, Radiology Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
A Vega - Interventional Neuroradiology, Radiology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
P Ruiz - Interventional Neuroradiology, Radiology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
J L Caniego - Interventional Neuroradiology, Radiology Department, Hospital Universitario La Princesa, Madrid, Spain
E Bárcena - Interventional Neuroradiology, Radiology Department, Hospital Universitario La Princesa, Madrid, Spain
P Saura - Interventional Neuroradiology, Radiology Department, Fundación Jiménez-Díaz, Madrid, Spain
J C Méndez - Interventional Neuroradiology, Radiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
F Delgado - Interventional Neuroradiology, Radiology Department, Hospital Reina Sofía, Córdoba, Spain
S Ortega-Gutierrez - Interventional Neuroradiology/Endovascular Neurosurgery Division, Department of Neurology, Neurosurgery, Radiology and Anesthesia, University of Iowa, Iowa City, Iowa, USA
A Romance - Interventional Neuroradiology, Radiology Department, Hospital Universitario Carlos Haya, Málaga, Spain
T Diaz - Interventional Neuroradiology, Radiology Department, Hospital Universitario Carlos Haya, Málaga, Spain
E Gonzalez - Interventional Neuroradiology, Radiology Department, Hospital de Cruces, Bilbao, Spain
A Gil - Interventional Neuroradiology, Radiology Department, Hospital de Cruces, Bilbao, Spain
E Murias - Interventional Neuroradiology, Radiology Department, Hospital Universitario de Oviedo, Oviedo, Asturias, Spain
P Vega - Interventional Neuroradiology, Radiology Department, Hospital Universitario de Oviedo, Oviedo, Asturias, Spain
Resource Type: Journal article
Publication Details: Journal of neurointerventional surgery, Vol.8(4), pp.396-401
DOI: 10.1136/neurintsurg-2015-011669
PMID: 25770120
NLM abbreviation: J Neurointerv Surg
ISSN: 1759-8478
eISSN: 1759-8486
Language: English
Date published: 04/2016
Academic Unit: Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984020619802771

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