Background: Flow diverting stents offer a promising treatment option for complex aneurysms.
Objective: To evaluate the safety and efficacy of the Pipeline Embolization Device (PED) in the treatment of fusiform and dissecting aneurysms.
Methods: 65 consecutive patients with 69 fusiform and dissecting aneurysms underwent endovascular treatment using the PED. Target vessels included the ICA (n=28), MCA (n=2), ACA (n=1) VA (n=20), BA (n=17) and PCA (n=1). An average of 3.0 PEDs per target vessel was deployed.
Results: Exclusion of the aneurysm(s) immediately after PED deployment was not observed. Angiographic follow-up examinations were carried out in 63/65 patients (67/69 lesions). They showed complete cure of the target lesion in the first follow-up angiography (3.4 months mean interval) in 24 (36%) cases, partial elimination in 30 (45%), and no improvement in 13 (19%). After the latest follow-up (>1 DSA, n= 49, 27.4 months mean interval) complete cure of the target lesion was observed in 33 (67%), partial elimination in 14 (29%), and no change in 2 (4%). Taking all follow-up examinations together, 39/67 (58%) aneurysms were cured. The morbidity and mortality in the entire series were 5% and 8%, respectively.
Conclusion: Flow diverters offer a promising treatment option in fusiform and dissecting aneurysms. The introduction of flow-diverters with different densities might help to identify the optimal amount of coverage needed given different anatomical presentations of fusiform and dissecting aneurysms.
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