Abstract
The PED is a flow-diverting stent designed for the treatment of cerebral aneurysms. We report 4 cases of delayed ipsilateral IPH following the technically successful treatment of anterior circulation aneurysms with the PED. Clinical and imaging data from all patients undergoing aneurysm treatment with the PED at 2 institutions were analyzed to assess the incidence of delayed IPH after treatment with the PED. A total of 66 patients (47 anterior circulation) with cerebral aneurysms underwent treatment with a PED between January 2008 and November 2010. Four patients experienced delayed periprocedural IPH, all after the treatment of anterior circulation aneurysms (8.5%, 4/47). The aneurysm size ranged from 5 to 21 mm. All IPHs occurred within the cerebral hemisphere, ipsilateral to the treated aneurysm, and were anatomically remote from the treated aneurysms. All procedures were uncomplicated, and patients emerged from general anesthesia at neurologic baseline. The hemorrhages became clinically evident between 1 and 6 days after the procedure. Two patients had unfavorable outcomes (mRS scores, 4 and 6). Delayed IPH may occur after the treatment of anterior circulation aneurysms with flow diverters. This complication does not seem to be restricted to a specific aneurysm subtype and does not seem to be related to an intraprocedural complication or solely attributable to DAT.
Highlights
AND PURPOSE: The PED is a flow-diverting stent designed for the treatment of cerebral aneurysms
Delayed IPH may occur after the treatment of anterior circulation aneurysms with flow diverters
We report 4 cases of delayed ipsilateral IPH following the treatment of anterior circulation aneurysms with the PED
Summary
Clinical and imaging data from all patients undergoing aneurysm treatment with the PED at 2 institutions were analyzed to assess the incidence of delayed IPH after treatment with the PED. Data Collection All patients treated with the PED (ev3/Covidian, Irvine, California) between January 2008 and November 2010 at 2 different institutions. Received November 23, 2011; accepted after revision January 25, 2012. From the Division of Neurosurgery (M.C., C.O.), Department of Surgery, University of Edmonton, Edmonton, Alberta, Canada; Department of Medical Imaging (J.P.C., J.S., W.M., T.M.), University of Toronto, Toronto, Ontario, Canada; Division of Neurosurgery (J.S.), Department of Surgery, University of Toronto, Saint Michael’s Hospital, Toronto, Ontario, Canada; Sydney Medical School (B.M.), University of Sydney, Sydney, New South Wales, Australia; and Department of Neurosurgery (D.F.), Cerebrovascular Center, Stony Brook University Medical Center, Stony Brook, New York. Paper previously presented as a Flash Presentation (3 minutes long, 5 slides) at: Annual Meeting of the World Federation of Interventional and Therapeutic Neuroradiology, Cape Town, South Africa; November 8, 2011
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