Early postmarket results after treatment of intracranial aneurysms with the pipeline embolization device: A US multicenter experience

Peter Kan; Adnan H. Siddiqui; Erol Veznedaroglu; Kenneth M. Liebman; Mandy J. Binning; Travis M. Dumont; Christopher S. Ogilvy; John R. Gaughen; J. Mocco; Gregory J. Velat; Andrew J. Ringer; Babu G. Welch; Michael B. Horowitz; Kenneth V. Snyder; L. Nelson Hopkins; Elad I. Levy

doi:10.1227/NEU.0b013e31827060d9

Early postmarket results after treatment of intracranial aneurysms with the pipeline embolization device: A US multicenter experience

Peter Kan, Adnan H. Siddiqui, Erol Veznedaroglu, Kenneth M. Liebman, Mandy J. Binning, Travis M. Dumont, Christopher S. Ogilvy, John R. Gaughen, J. Mocco, Gregory J. Velat, Andrew J. Ringer, Babu G. Welch, Michael B. Horowitz, Kenneth V. Snyder, L. Nelson Hopkins, Elad I. Levy

Research output: Contribution to journal › Article › peer-review

139 Scopus citations

Abstract

BACKGROUND: The Pipeline embolization device (PED) is the latest technology available for intracranial aneurysm treatment. OBJECTIVE: To report early postmarket results with the PED. METHODS: This study was a prospective registry of patients treated with PEDs at 7 American neurosurgical centers subsequent to Food and Drug Administration approval of this device. Data collected included clinical presentation, aneurysm characteristics, treatment details, and periprocedural events. Follow-up data included degree of aneurysm occlusion and delayed (>30 days after the procedure) complications. RESULTS: Sixty-two PED procedures were performed to treat 58 aneurysms in 56 patients. Thirty-seven of the aneurysms (64%) treated were located from the cavernous to the superior hypophyseal artery segment of the internal carotid artery; 22% were distal to that segment, and 14% were in the vertebrobasilar system. A total of 123 PEDs were deployed with an average of 2 implanted per aneurysm treated. Six devices were incompletely deployed; in these cases, rescue balloon angioplasty was required. Six periprocedural (during the procedure/within 30 days after the procedure) thromboembolic events occurred, of which 5 were in patients with vertebrobasilar aneurysms. There were 4 fatal postprocedural hemorrhages (from 2 giant basilar trunk and 2 large ophthalmic artery aneurysms). The major complication rate (permanent disability/death resulting from perioperative/delayed complication) was 8.5%. Among 19 patients with 3-month follow-up angiography, 68% (13 patients) had complete aneurysm occlusion. Two patients presented with delayed flow-limiting in-stent stenosis that was successfully treated with angioplasty. CONCLUSION: Unlike conventional coil embolization, aneurysm occlusion with PED is not immediate. Early complications include both thromboembolic and hemorrhagic events and appear to be significantly more frequent in association with treatment of vertebrobasilar aneurysms.

Original language	English (US)
Pages (from-to)	1080-1087
Number of pages	8
Journal	Neurosurgery
Volume	71
Issue number	6
DOIs	https://doi.org/10.1227/NEU.0b013e31827060d9
State	Published - Dec 2012

Keywords

Endovascular treatment
Flow diversion
Intracranial aneurysm
Pipeline device

ASJC Scopus subject areas

Surgery
Clinical Neurology

Access to Document

10.1227/NEU.0b013e31827060d9

Cite this

Kan, P., Siddiqui, A. H., Veznedaroglu, E., Liebman, K. M., Binning, M. J., Dumont, T. M., Ogilvy, C. S., Gaughen, J. R., Mocco, J., Velat, G. J., Ringer, A. J., Welch, B. G., Horowitz, M. B., Snyder, K. V., Hopkins, L. N., & Levy, E. I. (2012). Early postmarket results after treatment of intracranial aneurysms with the pipeline embolization device: A US multicenter experience. Neurosurgery, 71(6), 1080-1087. https://doi.org/10.1227/NEU.0b013e31827060d9

Kan, P, Siddiqui, AH, Veznedaroglu, E, Liebman, KM, Binning, MJ, Dumont, TM, Ogilvy, CS, Gaughen, JR, Mocco, J, Velat, GJ, Ringer, AJ, Welch, BG, Horowitz, MB, Snyder, KV, Hopkins, LN & Levy, EI 2012, 'Early postmarket results after treatment of intracranial aneurysms with the pipeline embolization device: A US multicenter experience', Neurosurgery, vol. 71, no. 6, pp. 1080-1087. https://doi.org/10.1227/NEU.0b013e31827060d9

@article{cd927b6faded4429ba8cf102d106aaf3,

title = "Early postmarket results after treatment of intracranial aneurysms with the pipeline embolization device: A US multicenter experience",

abstract = "BACKGROUND: The Pipeline embolization device (PED) is the latest technology available for intracranial aneurysm treatment. OBJECTIVE: To report early postmarket results with the PED. METHODS: This study was a prospective registry of patients treated with PEDs at 7 American neurosurgical centers subsequent to Food and Drug Administration approval of this device. Data collected included clinical presentation, aneurysm characteristics, treatment details, and periprocedural events. Follow-up data included degree of aneurysm occlusion and delayed (>30 days after the procedure) complications. RESULTS: Sixty-two PED procedures were performed to treat 58 aneurysms in 56 patients. Thirty-seven of the aneurysms (64%) treated were located from the cavernous to the superior hypophyseal artery segment of the internal carotid artery; 22% were distal to that segment, and 14% were in the vertebrobasilar system. A total of 123 PEDs were deployed with an average of 2 implanted per aneurysm treated. Six devices were incompletely deployed; in these cases, rescue balloon angioplasty was required. Six periprocedural (during the procedure/within 30 days after the procedure) thromboembolic events occurred, of which 5 were in patients with vertebrobasilar aneurysms. There were 4 fatal postprocedural hemorrhages (from 2 giant basilar trunk and 2 large ophthalmic artery aneurysms). The major complication rate (permanent disability/death resulting from perioperative/delayed complication) was 8.5%. Among 19 patients with 3-month follow-up angiography, 68% (13 patients) had complete aneurysm occlusion. Two patients presented with delayed flow-limiting in-stent stenosis that was successfully treated with angioplasty. CONCLUSION: Unlike conventional coil embolization, aneurysm occlusion with PED is not immediate. Early complications include both thromboembolic and hemorrhagic events and appear to be significantly more frequent in association with treatment of vertebrobasilar aneurysms.",

keywords = "Endovascular treatment, Flow diversion, Intracranial aneurysm, Pipeline device",

author = "Peter Kan and Siddiqui, {Adnan H.} and Erol Veznedaroglu and Liebman, {Kenneth M.} and Binning, {Mandy J.} and Dumont, {Travis M.} and Ogilvy, {Christopher S.} and Gaughen, {John R.} and J. Mocco and Velat, {Gregory J.} and Ringer, {Andrew J.} and Welch, {Babu G.} and Horowitz, {Michael B.} and Snyder, {Kenneth V.} and Hopkins, {L. Nelson} and Levy, {Elad I.}",

year = "2012",

month = dec,

doi = "10.1227/NEU.0b013e31827060d9",

language = "English (US)",

volume = "71",

pages = "1080--1087",

journal = "Neurosurgery",

issn = "0148-396X",

publisher = "Lippincott Williams and Wilkins Ltd.",

number = "6",

}

TY - JOUR

T1 - Early postmarket results after treatment of intracranial aneurysms with the pipeline embolization device

T2 - A US multicenter experience

AU - Kan, Peter

AU - Siddiqui, Adnan H.

AU - Veznedaroglu, Erol

AU - Liebman, Kenneth M.

AU - Binning, Mandy J.

AU - Dumont, Travis M.

AU - Ogilvy, Christopher S.

AU - Gaughen, John R.

AU - Mocco, J.

AU - Velat, Gregory J.

AU - Ringer, Andrew J.

AU - Welch, Babu G.

AU - Horowitz, Michael B.

AU - Snyder, Kenneth V.

AU - Hopkins, L. Nelson

AU - Levy, Elad I.

PY - 2012/12

Y1 - 2012/12

N2 - BACKGROUND: The Pipeline embolization device (PED) is the latest technology available for intracranial aneurysm treatment. OBJECTIVE: To report early postmarket results with the PED. METHODS: This study was a prospective registry of patients treated with PEDs at 7 American neurosurgical centers subsequent to Food and Drug Administration approval of this device. Data collected included clinical presentation, aneurysm characteristics, treatment details, and periprocedural events. Follow-up data included degree of aneurysm occlusion and delayed (>30 days after the procedure) complications. RESULTS: Sixty-two PED procedures were performed to treat 58 aneurysms in 56 patients. Thirty-seven of the aneurysms (64%) treated were located from the cavernous to the superior hypophyseal artery segment of the internal carotid artery; 22% were distal to that segment, and 14% were in the vertebrobasilar system. A total of 123 PEDs were deployed with an average of 2 implanted per aneurysm treated. Six devices were incompletely deployed; in these cases, rescue balloon angioplasty was required. Six periprocedural (during the procedure/within 30 days after the procedure) thromboembolic events occurred, of which 5 were in patients with vertebrobasilar aneurysms. There were 4 fatal postprocedural hemorrhages (from 2 giant basilar trunk and 2 large ophthalmic artery aneurysms). The major complication rate (permanent disability/death resulting from perioperative/delayed complication) was 8.5%. Among 19 patients with 3-month follow-up angiography, 68% (13 patients) had complete aneurysm occlusion. Two patients presented with delayed flow-limiting in-stent stenosis that was successfully treated with angioplasty. CONCLUSION: Unlike conventional coil embolization, aneurysm occlusion with PED is not immediate. Early complications include both thromboembolic and hemorrhagic events and appear to be significantly more frequent in association with treatment of vertebrobasilar aneurysms.

AB - BACKGROUND: The Pipeline embolization device (PED) is the latest technology available for intracranial aneurysm treatment. OBJECTIVE: To report early postmarket results with the PED. METHODS: This study was a prospective registry of patients treated with PEDs at 7 American neurosurgical centers subsequent to Food and Drug Administration approval of this device. Data collected included clinical presentation, aneurysm characteristics, treatment details, and periprocedural events. Follow-up data included degree of aneurysm occlusion and delayed (>30 days after the procedure) complications. RESULTS: Sixty-two PED procedures were performed to treat 58 aneurysms in 56 patients. Thirty-seven of the aneurysms (64%) treated were located from the cavernous to the superior hypophyseal artery segment of the internal carotid artery; 22% were distal to that segment, and 14% were in the vertebrobasilar system. A total of 123 PEDs were deployed with an average of 2 implanted per aneurysm treated. Six devices were incompletely deployed; in these cases, rescue balloon angioplasty was required. Six periprocedural (during the procedure/within 30 days after the procedure) thromboembolic events occurred, of which 5 were in patients with vertebrobasilar aneurysms. There were 4 fatal postprocedural hemorrhages (from 2 giant basilar trunk and 2 large ophthalmic artery aneurysms). The major complication rate (permanent disability/death resulting from perioperative/delayed complication) was 8.5%. Among 19 patients with 3-month follow-up angiography, 68% (13 patients) had complete aneurysm occlusion. Two patients presented with delayed flow-limiting in-stent stenosis that was successfully treated with angioplasty. CONCLUSION: Unlike conventional coil embolization, aneurysm occlusion with PED is not immediate. Early complications include both thromboembolic and hemorrhagic events and appear to be significantly more frequent in association with treatment of vertebrobasilar aneurysms.

KW - Endovascular treatment

KW - Flow diversion

KW - Intracranial aneurysm

KW - Pipeline device

UR - http://www.scopus.com/inward/record.url?scp=84870064368&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84870064368&partnerID=8YFLogxK

U2 - 10.1227/NEU.0b013e31827060d9

DO - 10.1227/NEU.0b013e31827060d9

M3 - Article

C2 - 22948199

AN - SCOPUS:84870064368

SN - 0148-396X

VL - 71

SP - 1080

EP - 1087

JO - Neurosurgery

JF - Neurosurgery

IS - 6

ER -

Early postmarket results after treatment of intracranial aneurysms with the pipeline embolization device: A US multicenter experience

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this