Purpose: Aneurysmal recurrence represents a significant drawback of endovascular coiling, particularly in aneurysms that have previously ruptured. Given the high recurrence rate of coiled aneurysms and particularly the risk of posttreatment rupture in previously ruptured aneurysms that have been treated by coiling, the question of how best to treat ruptured aneurysms that recur postcoiling remains.
Materials And Methods: We conducted a retrospective analysis of twenty patients who underwent pipeline embolization of previously ruptured, coiled cerebral aneurysms.
Results: Pipeline embolization device (PED) treatment resulted in complete aneurysmal occlusion in 10 patients (62.5%) at first angiographic follow-up, and 11 patients (68.75%) at last follow-up. No PED-related complications were encountered and there were no peri-procedural or postprocedural hemorrhages, or symptomatic ischemic events following flow diversion.
Conclusions: PED as a second-line treatment is a safe and effective modality for achieving aneurysmal occlusion in recurrent, previously ruptured, primarily coiled aneurysms. Additionally, a staged coil-to-PED approach may be considered for the management of acutely ruptured aneurysms to achieve aneurysmal obliteration in an effort to mitigate recurrence, and reduce the amount of postprocedural studies.
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http://dx.doi.org/10.4103/bc.bc_59_20 | DOI Listing |
J Clin Neurosci
December 2024
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.
Methods: We conducted a retrospective analysis of a prospectively maintained database and identified 125 consecutive patients with treatment naïve intracranial aneurysms who underwent flow diversion with the PED from April 2014 - November 2022.
J Neurol Sci
December 2024
Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA. Electronic address:
Introduction: The FRED-X is a newer generation flow diverting stent (FDS) with surface modification that has demonstrated favorable efficacy in treating intracranial aneurysms. Our study provides an analysis of patients treated using FRED-X compared to FRED, PED Shield and PED.
Materials And Methods: This was a retrospective single center study and a systematic review with network meta analysis of patients who underwent flow diversion using FRED-X, FRED, PED Shield or PED.
AJNR Am J Neuroradiol
December 2024
Surg Neurol Int
November 2024
Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma, United States.
Background: Iatrogenic injury to neck vasculature is a potentially life-threatening complication of spine surgery. We present an illustrative case describing the use of the Pipeline Embolization Device (PED) in the emergent reconstruction of the vertebral artery (VA) following vessel laceration. In addition, we document a systematic review concerning the use of the PED in acute to chronic iatrogenic injury of the internal carotid or VAs.
View Article and Find Full Text PDFInterv Neuroradiol
December 2024
Department of Neurology, University of Chicago, Chicago, IL, USA.
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