TY - JOUR
T1 - International retrospective study of the pipeline embolization device
T2 - A multicenter aneurysm treatment study
AU - Kallmes, David F.
AU - Hanel, R.
AU - Lopes, D.
AU - Boccardi, E.
AU - Bonafé, A.
AU - Cekirge, S.
AU - Fiorella, D.
AU - Jabbour, P.
AU - Levy, E.
AU - McDougall, C.
AU - Siddiqui, A.
AU - Szikora, I.
AU - Woo, H.
AU - Albuquerque, F.
AU - Bozorgchami, H.
AU - Dashti, S. R.
AU - Almandoz, J. E.Delgado
AU - Kelly, M. E.
AU - Turner, R. I.
AU - Woodward, B. K.
AU - Brinjikji, W.
AU - Lanzino, G.
AU - Lylyk, P.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Background and Purpose: Flow diverters are increasingly used in the endovascular treatment of intracranial aneurysms. Our aim was to determine neurologic complication rates following Pipeline Embolization Device placement for intracranial aneurysm treatment in a real-world setting. Materials and Methods: We retrospectively evaluated all patients with intracranial aneurysms treated with the Pipeline Embolization Device between July 2008 and February 2013 in 17 centers worldwide. We defined 4 subgroups: internal carotid artery aneurysms of ≥10 mm, ICA aneurysms of<10 mm, other anterior circulation aneurysms, and posterior circulation aneurysms. Neurologic complications included spontaneous rupture, intracranial hemorrhage, ischemic stroke, permanent cranial neuropathy, and mortality. Comparisons were made with t tests or ANOVAs for continuous variables and the Pearson x2 or Fisher exact test for categoric variables. Results: In total, 793 patients with 906 aneurysms were included. The neurologic morbidity and mortality rate was 8.4% (67/793), highest in the posterior circulation group (16.4%, 9/55) and lowest in the ICA<10-mm group (4.8%, 14/294) (P=.01). The spontaneous rupture rate was 0.6% (5/793). The intracranial hemorrhage rate was 2.4% (19/793). Ischemic stroke rates were 4.7% (37/793), highest in patients with posterior circulation aneurysms (7.3%, 4/55) and lowest in the ICA <10-mm group (2.7%, 8/294) (P = .16). Neurologic mortality was 3.8% (30/793), highest in the posterior circulation group (10.9%, 6/55) and lowest in the anterior circulation ICA<10-mm group (1.4%, 4/294) (P<.01). Conclusions: Aneurysm treatment with the Pipeline Embolization Device is associated with the lowest complication rates when used to treat small ICA aneurysms. Procedure-related morbidity and mortality are higher in the treatment of posterior circulation and giant aneurysms.
AB - Background and Purpose: Flow diverters are increasingly used in the endovascular treatment of intracranial aneurysms. Our aim was to determine neurologic complication rates following Pipeline Embolization Device placement for intracranial aneurysm treatment in a real-world setting. Materials and Methods: We retrospectively evaluated all patients with intracranial aneurysms treated with the Pipeline Embolization Device between July 2008 and February 2013 in 17 centers worldwide. We defined 4 subgroups: internal carotid artery aneurysms of ≥10 mm, ICA aneurysms of<10 mm, other anterior circulation aneurysms, and posterior circulation aneurysms. Neurologic complications included spontaneous rupture, intracranial hemorrhage, ischemic stroke, permanent cranial neuropathy, and mortality. Comparisons were made with t tests or ANOVAs for continuous variables and the Pearson x2 or Fisher exact test for categoric variables. Results: In total, 793 patients with 906 aneurysms were included. The neurologic morbidity and mortality rate was 8.4% (67/793), highest in the posterior circulation group (16.4%, 9/55) and lowest in the ICA<10-mm group (4.8%, 14/294) (P=.01). The spontaneous rupture rate was 0.6% (5/793). The intracranial hemorrhage rate was 2.4% (19/793). Ischemic stroke rates were 4.7% (37/793), highest in patients with posterior circulation aneurysms (7.3%, 4/55) and lowest in the ICA <10-mm group (2.7%, 8/294) (P = .16). Neurologic mortality was 3.8% (30/793), highest in the posterior circulation group (10.9%, 6/55) and lowest in the anterior circulation ICA<10-mm group (1.4%, 4/294) (P<.01). Conclusions: Aneurysm treatment with the Pipeline Embolization Device is associated with the lowest complication rates when used to treat small ICA aneurysms. Procedure-related morbidity and mortality are higher in the treatment of posterior circulation and giant aneurysms.
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U2 - 10.3174/ajnr.A4111
DO - 10.3174/ajnr.A4111
M3 - Article
C2 - 25355814
AN - SCOPUS:84920983511
SN - 0195-6108
VL - 36
SP - 108
EP - 115
JO - American Journal of Neuroradiology
JF - American Journal of Neuroradiology
IS - 1
ER -