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Single Center Experience With Pipeline Stent: Feasibility, Technique, and Complications

Chitale, Rohan MD; Gonzalez, L. Fernando MD; Randazzo, Ciro MD; Dumont, Aaron S. MD; Tjoumakaris, Stavropoula MD; Rosenwasser, Robert MD; Chalouhi, Nohra MD; Gordon, David MD; Jabbour, Pascal MD

doi: 10.1227/NEU.0b013e318260fe86
Research-Human-Clinical Studies

BACKGROUND: Endovascular coil embolization is an established method of treatment for intracranial aneurysms. The pipeline embolization device (PED) is a low-porosity endovascular stent designed to reconstruct the parent artery and decrease blood flow into the aneurysm.

OBJECTIVE: To report a series of 36 patients treated with the PED.

METHODS: Thirty-six patients underwent PED placement for aneurysm at the Jefferson Hospital for Neuroscience from October 2010 to November 2011. Clinical charts were reviewed.

RESULTS: Thirty-six patients with 42 aneurysms were treated (3 male; 33 female; ages, 34–82; mean age, 60.1 years). Forty-one aneurysms were located in the anterior circulation, whereas one was located at the vertebrobasilar junction. PED placement was successful in all patients and resulted in stasis within all treated aneurysms. Symptomatic postoperative complications were witnessed in 13.9% (n = 5) of patients. These complications included intracerebral hemorrhage (n = 4), dissection (n = 1), symptomatic stroke (n = 2), and death (n = 1).

CONCLUSION: Treatment of simple or complex intracranial aneurysms with PEDs alone or in conjunction with coil embolization is technically feasible, and the deployment technique requires a high degree of endovascular skills. Major perioperative adverse events must be studied. Respect for the indications of the procedure is crucial to justify the risk.

ABBREVIATION: PED, pipeline embolization device

Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania

Correspondence: Pascal M. Jabbour, MD, Assistant Professor, Department of Neurological Surgery, Division of Neurovascular Surgery and Endovascular Neurosurgery, Thomas Jefferson University Hospital, 909 Walnut St, 2nd Floor, Philadelphia PA 19107. E-mail: pascal.jabbour@jefferson.edu

Received November 17, 2011

Accepted May 9, 2012

Copyright © by the Congress of Neurological Surgeons