A Study on the Efficacy and Safety of Pipeline Shield Stents and Nonmodified Surface Flow-Diverting Stents in Patients with Intracranial Aneurysms

Abstract

IntroductionFew studies have compared the Pipeline Shield stents with previous generations of flow-diverting stents (FDs) for treating unruptured intracranial aneurysms (UIA). This study aimed to evaluate the efficacy and safety of Pipeline Shield stents and FDs without modified surfaces. Materials and MethodsThe present evaluation is a retrospective cohort study of patients endovascularly treated with Pipeline Shield stents or flow-diverting (FD) stents without modified surfaces for UIA between January 2014 and June 2022. The data analyzed was obtained from the anonymized database of the institution's Interventional Radiology service. Results147 patients with 155 UIA were included. 96 of them were treated with Pipeline Shield stents and 59 with FDs without modified surfaces. The aneurysms treated with Pipeline Shield stents had higher six-month (OKM D; 87.5 % vs. 71.4 %, p-value: 0.025) and one-year (OKM D; 82.5 % vs. 63.0 %, p-value: 0.047) occlusion rates than aneurysms treated using FDs without modified surfaces. No differences between the devices were found at the one-year follow-up in ischemic stroke (p-value: 0.939) and hemorrhagic complications (p-value: 0.559). ConclusionPipeline Shield stents demonstrated superior complete occlusion rates (OKM D) at both the six-month and one-year follow-up assessments when compared to non-modified surface FDs. There were no significant differences in the safety profiles between the two types of stents with regard to thromboembolic complications and ischemic events. Further research with larger study populations is necessary to validate these findings.