Background: Microsurgical clipping is regarded as the most durable treatment for cerebral aneurysms. Aneurysm recurrence after clipping is uncommon and is associated with an increased risk of rupture. Reoperation for recurrent cerebral aneurysms is particularly challenging because of adhesions and scaring, and it carries a higher rate of morbidity and mortality. Pipeline embolization as a treatment option for recurrent aneurysms has rarely been reported.
Methods: A retrospective analysis of patients who underwent Pipeline Embolization Device (PED) placement for recurrent aneurysms after clipping at two major academic institutions in the United States was performed.
Results: Seven patients were identified. The median time between initial clipping and diagnosis of recurrence was 13 years (range, 5-20 years). No morbidity or mortality was associated with PED placement. Complete occlusion was achieved in all patients with imaging follow-up. A history of prior clipping did not affect PED placement or outcome.
Conclusions: PED for recurrent aneurysms after clipping may be a feasible alternative to reoperation. In our experience, treatment with PED for these aneurysms is safe and efficacious.
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| http://dx.doi.org/10.1016/j.wneu.2016.06.065 | DOI Listing |
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Evolving treatment paradigms of cerebral aneurysm stasis in flow diversion.
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Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Electronic address:
Introduction: Flow diversion is an effective first-line treatment for intracranial aneurysms; however, the rate of incomplete occlusion is not insignificant. Data in neuroendovascular literature is limited regarding the implications of persistent incomplete occlusion despite flow diversion.
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Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA. Electronic address:
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View Article and Find Full Text PDFFourth-generation Pipeline Vantage flow diversion: First reported US experience of safety and feasibility.
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Article Synopsis
- The Pipeline Vantage embolization device is a new fourth-generation tool designed to treat intracranial aneurysms, and this study evaluates its safety and effectiveness.
- The research involved 12 patients, primarily women, with a variety of aneurysm types, and demonstrated a 100% success rate in device deployment without intraoperative complications.
- One postprocedural complication occurred, and the findings represent the first US analysis of this device's use in patients with intracranial aneurysms, highlighting its potential for treating both ruptured and unruptured cases.
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