Pipeline embolization device for the treatment of intracranial aneurysms: a preliminary experience

Abstract

Objective To investigate the clinical application value and technical characteristics of pipeline embolization device(PED)for the treatment of intracranial aneurysms. Methods From December 2014 to December 2015, the clinical data of 20 patients with intracranial aneurysm treated with PED at the Department of Neurosurgeries, Shanghai Punan Hospital of Pudong New District and Donglei Brain Surgeon Group were analyzed retrospectively. Fifteen patients had one aneurysm and 5 had multiple aneurysms. The diameters of 28 aneurysms were 2-33 mm(15.2±9.9 mm). The aneurysm necks of all patients were covered with 1 PED, and 8 of them were treated with the combined aneurysm coil embolization. Results The release of PEDs in all 20 patients was completed successfully. The coverage of aneurysm necks was satisfactory. PEDs were found well adhering to the wall. Immediately after surgery, it showed that contrast agents in aneurysm cavities were obviously detained. Three patients had complications of cerebral hemorrhage after procedure, including 1 died and 1 had hemiparesis at discharge. Eight patients were followed up by digital subtraction angiography(DSA)6 months later, 6 were cured completely, the aneurysm of 1 case was nearly completely occluded, and the size of a large aneurysm did not have obvious change. Two patients had asymptomatic anterior cerebral artery stenosis. The head MRI follow-up revealed that the mass effect of the large and giant intracranial aneurysms were significantly relieved or disappeared. The remaining 11 cases had to be followed up. Conclusions The efficacy of PED for the treatment of large and giant intracranial aneurysms, tandem multiple small aneurysms and intracranial blood blister-like aneurysms is satisfactory. This device has just begun to be applied in clinical practice in China. The complications and long-term efficacy of the large sample case analysis and research are needed. Key words: Intracranial aneurysm; Embolization, therapeutic; Pipeline embolization device