Spontaneous delayed migration/shortening of the pipeline embolization device: report of 5 cases

N Chalouhi; S I Tjoumakaris; L F Gonzalez; D Hasan; P J Pema; G Gould; R H Rosenwasser; P M Jabbour

doi:10.3174/ajnr.A3632

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Spontaneous delayed migration/shortening of the pipeline embolization device: report of 5 cases

Journal article

Open access

Peer reviewed

Spontaneous delayed migration/shortening of the pipeline embolization device: report of 5 cases

N Chalouhi, S I Tjoumakaris, L F Gonzalez, D Hasan, P J Pema, G Gould, R H Rosenwasser and P M Jabbour

American journal of neuroradiology : AJNR, Vol.34(12), pp.2326-2330

12/2013

DOI: 10.3174/ajnr.A3632

PMID: 23811979

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Abstract

Five patients were found to have spontaneous delayed migration/shortening of their Pipeline Embolization Devices on follow-up angiography. The device migrated proximally in 4 patients and distally in 1 patient. One patient had a subarachnoid hemorrhage and died as a result of migration of the Pipeline Embolization Device, and another patient presented with complete MCA occlusion and was left severely disabled. Mismatch in arterial diameter between inflow and outflow vessels was a constant finding. Migration of the Pipeline Embolization Device was managed conservatively, with additional placement of the device, or with parent vessel occlusion. Obtaining complete expansion of the embolization device by using a longer device, increasing vessel coverage, using adjunctive aneurysm coiling, and avoiding dragging and stretching of the device are important preventive measures. Neurointerventionalists should be aware of this potentially fatal complication and take all necessary preventive measures.

Foreign-Body Migration - etiology

Embolization, Therapeutic - instrumentation

Intracranial Aneurysm - diagnostic imaging

Humans

Middle Aged

Male

Intracranial Aneurysm - complications

Equipment Design

Embolization, Therapeutic - adverse effects

Foreign-Body Migration - diagnostic imaging

Radiography

Subarachnoid Hemorrhage - prevention & control

Intracranial Aneurysm - therapy

Treatment Failure

Fatal Outcome

Subarachnoid Hemorrhage - etiology

Adult

Female

Aged

Stents - adverse effects

Equipment Failure

Details

Title: Subtitle: Spontaneous delayed migration/shortening of the pipeline embolization device: report of 5 cases
Creators: N Chalouhi - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania
S I Tjoumakaris
L F Gonzalez
D Hasan
P J Pema
G Gould
R H Rosenwasser
P M Jabbour
Resource Type: Journal article
Publication Details: American journal of neuroradiology : AJNR, Vol.34(12), pp.2326-2330
DOI: 10.3174/ajnr.A3632
PMID: 23811979
NLM abbreviation: AJNR Am J Neuroradiol
ISSN: 0195-6108
eISSN: 1936-959X
Publisher: United States
Language: English
Date published: 12/2013
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Neurosurgery; Otolaryngology
Record Identifier: 9984040231302771

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