The short-term efficacy of Pipeline embolization device for the treatment of complex intracranial aneurysms

Abstract

Objective To observe the short-term efficacy of Pipeline embolization device (PED) for the treatment of complex intracranial aneurysms. Methods The clinical data of 27 consecutive patients with 28 intracranial aneurysms treated with PED at Department of Neurosurgery the First Hospital of Xinjiang Medical University between April 2015 to July 2016 were analyzed retrospectively. PED were implanted in 10 out of the 27 patients, PED combined with coils in 17 patients, and 2 patients underwent balloon remodeling following PED implantation. Results We treated 27 aneurysms with 28 PEDs, all of which were successfully implanted. PED were placed across the ostia of 17 ophthalmic arteries, 9 posterior communicating arteries, 4 posterior inferior cerebellar arteries and 1 anterior cerebral artery. Immediate post-procedural angiography revealed occlusion in 1 (1/17) ophthalmic artery and 1 (1/9) posterior communicating artery, and no occlusion of branch vessels or stenosis of parent arteries occurred. Two cases of subarachnoid hemorrhage resulting in death occurred 2 hours and 5 days post surgery, respectively. At 6-month follow-up, 19 patients underwent whole-brain angiography and 4 patients received the examination of MRA, which revealed complete occlusion or near occlusion in 20 (87%, 20/23) cases as well as partial occlusion in 3 (13%, 3/23) cases without any stenosis of parent arteries. The branch arteries without immediate intraoperative occlusion remained well. No neurological deficits were reported in 25 patients who received clinical follow-up. Conclusion The PED seems to demonstrate a good short-term effect on the treatment of complex intracranial aneurysms with high rates of aneurysm occlusion and low risk of complications. Key words: Intracranial aneurysm; Cerebral revascularization; Treatment outcome; Pipeline embolization divice