Pipeline Embolization Device for Large/Giant or Fusiform Aneurysms: An Initial Multi-Center Experience in Korea.
10.5469/neuroint.2016.11.1.10
- Author:
Byung Moon KIM
1
;
Yong Sam SHIN
;
Min Woo BAIK
;
Deok Hee LEE
;
Pyoung JEON
;
Seung Kug BAIK
;
Tae Hong LEE
;
Dong Hoon KANG
;
Sang il SUH
;
Jun Soo BYUN
;
Jin Young JUNG
;
Kihun KWON
;
Dong Joon KIM
;
Keun Young PARK
;
Bum soo KIM
;
Jung Cheol PARK
;
Seong Rim KIM
;
Young Woo KIM
;
Hoon KIM
;
Kyungil JO
;
Chang Hyo YOON
;
Young Soo KIM
Author Information
1. Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. bmoon21@hanmail.net
- Publication Type:Multicenter Study ; Original Article
- Keywords:
Pipeline;
Flow diverter;
Aneurysm
- MeSH:
Aneurysm*;
Carotid Artery, Internal;
Follow-Up Studies;
Humans;
Korea*;
Learning;
Middle Cerebral Artery;
Mortality;
Retrospective Studies;
Thrombosis
- From:Neurointervention
2016;11(1):10-17
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The purpose of this study was to assess the safety and early outcomes of the Pipeline device for large/giant or fusiform aneurysms. MATERIALS AND METHODS: The Pipeline was implanted in a total of 45 patients (mean age, 58 years; M:F=10:35) with 47 large/giant or fusiform aneurysms. We retrospectively evaluated the characteristics of the treated aneurysms, the periprocedural events, morbidity and mortality, and the early outcomes after Pipeline implantation. RESULTS: The aneurysms were located in the internal carotid artery (ICA) cavernous segment (n=25), ICA intradural segment (n=11), vertebrobasilar trunk (n=8), and middle cerebral artery (n=3). Procedure-related events occurred in 18 cases, consisting of incomplete expansion (n=8), shortening-migration (n=5), transient occlusion of a jailed branch (n=3), and in-stent thrombosis (n=2). Treatment-related morbidity occurred in two patients, but without mortality. Both patients had modified Rankin scale (mRS) scores of 2, but had an improved mRS score of 0 at 1-month follow-up. Of the 19 patients presenting with mass effect, 16 improved but three showed no changes in their presenting symptoms. All patients had excellent outcomes (mRS, 0 or 1) during the follow-up period (median, 6 months; range, 2-30 months). Vascular imaging follow-up (n=31, 65.9%; median, 3 months, range, 1-25 months) showed complete or near occlusion of the aneurysm in 24 patients (77.4%) and decreased sac size in seven patients (22.6%). CONCLUSION: In this initial multicenter study in Korea, the Pipeline seemed to be safe and effective for large/giant or fusiform aneurysms. However, a learning period may be required to alleviate device-related events.