Evaluation of the safety and efficacy of a Pipeline Flex embolization device for treatment of large, wide-necked intracranial aneurysms

Qiao Deng, Wenfeng Feng, Huanqi Hai, Jianming Liu, Qiao Deng, Wenfeng Feng, Huanqi Hai, Jianming Liu

Abstract

Objective: To investigate the safety and effectiveness of the Pipeline Flex embolization device (PFED) in the treatment of large and wide-necked aneurysms in the internal carotid artery (ICA). Methods: The clinical data of 78 cases of large and wide-necked aneurysms in the ICA treated with this Pipeline Flex embolization device in Shanghai Hospital of the Second Military Medical University and Southern Hospital of Southern Medical University from February 2017 to June 2018 were retrospectively analyzed. Results: A total of 66 cases were treated with a Pipeline Flex embolization device, 10 with a pipeline flex embolization device, and 2 with a double tubride stent (10 patients were treated with a pipeline stent-assisted coil embolization in; and 2 patients were treated with two pipeline stents). The patients were followed up for 3 to 18 months (average, 9.25 months). Among them, 63 cases had complete occlusion of the neck of the aneurysm (Raymondl Class I; MRS score 0; 80.8%). Aneurysms recurred in 12 cases (Raymondl Class II; MRS score 1; 15.4%). Delayed ischemic complications were observed in 1 case (MRS score >2; 0.13%). There was 1 case of poor release of stent and 1 case of stent stenosis (0.13%). Conclusion: The treatment of large, wide-necked aneurysms in the ICA with PFED has a high total occlusion rate and good prognosis was better than coil embolization, but the placement of PFED still has some neurological complications.

Keywords: Pipeline Flex embolization device; curative effect; large, wide-necked aneurysms; neurological complications; vascular reconstruction device.

© 2018 Shanghai Journal of Interventional Medicine Press. Production and hosting by Elsevier B.V. on behalf of KeAi.

Figures

Figure 1.
Figure 1.
(A–G) Images of the treatment process of carotid cavernous segment aneurysms. (A) The anteroposterior position of digital subtraction angiography of the right ICA. (B) Lateral view of digital subtraction angiography of the right ICA. (C) Three-dimensional reconstruction of the aneurysm. (D) Positioning of the Pipeline Flex embolization device. (E) Three-dimensional reconstruction of the Pipeline Flex embolization device. (F) DSA examination after operation, showing that blood is directed to the distal end of the artery and does not pass through the aneurysm. (G) T1-weighted MRI shows a mixed and high signal. (H) Contrast-enhanced MRI in the aneurysm shows thrombosis.

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Source: PubMed

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