Journal article
The Experience With Flow Diverters in the Treatment of Posterior Inferior Cerebellar Artery Aneurysms
Operative neurosurgery (Hagerstown, Md.), Vol.17(1), pp.8-13
07/01/2019
DOI: 10.1093/ons/opy301
PMID: 30753682
Abstract
ABSTRACT
BACKGROUND
The use of the pipeline embolization device (PED; Medtronic, Dublin, Ireland) in the posterior circulation has been limited and infrequently reported compared to other off-label utilizations. Posterior inferior cerebellar artery aneurysms (PICAA) constitute 1 of the least reported posterior circulation aneurysms treated with PED. No clinical studies have addressed the treatment of these aneurysms with flow diversion exclusively.
OBJECTIVE
To appraise the feasibility and the safety of PED in the treatment of PICAAs.
METHODS
Data on 12 consecutive patients, treated between 2011-2017 with PED for their PICAA, was retrospectively reviewed. To control confounding, we used multivariable logistic regression and propensity score conditioning.
RESULTS
Of 534 patients, 12 (9/12, 75% males) were identified and constituted our study population. The average aneurysm size was 8.47 mm (SD = 2.6, 3.7-14). Patients were followed-up for an average of 10.3 months (SD = 11 mo). Two of 12 (16.7%) had a prior history of subarachnoid hemorrhage. Eight of 12 (67%) of the aneurysms were saccular, 3/12 (25%) were dolichoectatic, and 1/12 (8%) was a small blister aneurysm. Eleven of 12 (92%) aneurysms were treated with 1 PED; 2/12 (16.7%) patients received combined pipeline assisted coiling. All patients had a complete occlusion, regression, and resolution of their aneurysm(s). PED deployment was neither complicated with any hemorrhagic or clinically significant thromboembolic events nor with device migration in any of our patients. Three of 12 (25%) patients had a benign intrastent stenosis. No mortality, among our 12 patients, was noted throughout the follow-up period.
CONCLUSION
PED, deployed by specialized experts, should be safe in treating PICAA. It can be contemplated as a novel alternative treatment of aneurysms located at the PICA-VA bifurcation or within the PICA.
Details
- Title: Subtitle
- The Experience With Flow Diverters in the Treatment of Posterior Inferior Cerebellar Artery Aneurysms
- Creators
- Elias Atallah - Department of Neurological Surgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaHassan Saad - Department of Neurological Surgery, Arkansas Neuroscience Institute, CHI St. Vincent, Little Rock, ArkansasJonathan Li - Department of Neurological Surgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaAyan Kumar - Department of Neurological Surgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaStavropoula Tjoumakaris - Department of Neurological Surgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaNohra Chalouhi - Department of Neurological Surgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaDavid Hasan - Department of Neurological Surgery, Iowa University Hospital and Clinics, Iowa City, IowaHekmat Zarzour - Department of Neurological Surgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaNabeel Herial - Department of Neurological Surgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaMichael Reid Gooch - Department of Neurological Surgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaRobert H Rosenwasser - Department of Neurological Surgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaPascal Jabbour - Department of Neurological Surgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania
- Resource Type
- Journal article
- Publication Details
- Operative neurosurgery (Hagerstown, Md.), Vol.17(1), pp.8-13
- Publisher
- Oxford University Press
- DOI
- 10.1093/ons/opy301
- PMID
- 30753682
- ISSN
- 2332-4252
- eISSN
- 2332-4260
- Language
- English
- Date published
- 07/01/2019
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurosurgery; Otolaryngology
- Record Identifier
- 9984040013202771
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