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Pipeline embolization device

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https://www.readbyqxmd.com/read/27888225/use-of-the-pipeline-embolization-device-for-recurrent-and-residual-cerebral-aneurysms-a-safety-and-efficacy-analysis-with-short-term-follow-up
#1
Anna Luisa Kühn, Katyucia de Macedo Rodrigues, J Diego Lozano, David E Rex, Francesco Massari, Takamitsu Tamura, Mary Howk, Christopher Brooks, Jenna L'Heureux, Matthew J Gounis, Ajay K Wakhloo, Ajit S Puri
OBJECTIVE: Evaluation of the safety and efficacy of the Pipeline embolization device (PED) when used as second-line treatment for recurrent or residual, pretreated ruptured and unruptured intracranial aneurysms (IAs). METHODS: Retrospective review of our database to include all patients who were treated with a PED for recurrent or residual IAs following surgical clipping or coiling. We evaluated neurological outcome and angiograms at discharge, 6- and 12-months' follow-up and assessed intimal hyperplasia at follow-up...
November 25, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27863970/treatment-of-distal-anterior-cerebral-artery-aneurysms-with-the-pipeline-embolization-device
#2
Erez Nossek, Daniel W Zumofen, Avi Setton, Matthew B Potts, Eytan Raz, Maksim Shapiro, Howard A Riina, Maria Angeles De Miquel, David J Chalif, Peter K Nelson
Aneurysms of the anterior cerebral artery (ACA) located distal to the anterior communicating artery complex (ACOM) remain challenging to treat with surgical clip reconstruction as well as with endovascular coil-embolization strategies. We have treated five complex geometry distal ACA aneurysms with endoluminal reconstruction using the Pipeline Embolization Device (PED). Two aneurysms were of the dysplastic fusiform type. Three aneurysms were of complex saccular configuration. Three aneurysms were treated electively at the outset with PED...
November 15, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27829966/pipeline-embolization-device-for-treatment-of-intracranial-aneurysms-the-more-the-better-a-single-center-retrospective-observational-study
#3
Christoph Kabbasch, Anastasios Mpotsaris, Daniel Behme, Franziska Dorn, Pantelis Stavrinou, Thomas Liebig
OBJECTIVES: The pipeline embolization device (PED) is a treatment option for wide-neck intracranial aneurysms. The individual number of implants needed to securely exclude an aneurysm is unknown. Our primary objective was to compare midterm occlusion and complication rates in aneurysms treated with a single versus multiple PEDs without adjunctive coiling in a single procedure. PATIENTS AND METHODS: Fifty-five patients harboring 58 intracranial aneurysms were treated with 121 PEDs between March 2011 and December 2013...
October 2016: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/27799376/thrombogenicity-of-flow-diverters-in-an-ex-vivo-shunt-model-effect-of-phosphorylcholine-surface-modification
#4
Matthew W Hagen, Gaurav Girdhar, John Wainwright, Monica T Hinds
BACKGROUND: Flow diverters offer a promising treatment for cerebral aneurysms. However, they have associated thromboembolic risks, mandating chronic dual antiplatelet therapy (DAPT). Shield Technology is a phosphorylcholine surface modification of the Pipeline Embolization Device (PED) flow diverter, which has shown significant reductions in material thrombogenicity in vitro. OBJECTIVE: To compare the thrombogenicity of PED, PED with Shield Technology (PED+Shield), and the Flow-Redirection Endoluminal Device (FRED)-with and without single antiplatelet therapy and DAPT-under physiological flow...
October 31, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27798327/effects-on-vessel-measurement-accuracy-and-subsequent-occlusion-after-calcium-channel-blocker-infusion-during-treatment-of-cerebral-aneurysms-with-the-pipeline-embolization-device
#5
M D Alexander, A D Nicholson, R J Darflinger, F Settecase, D L Cooke, C F Dowd, M R Amans, R T Higashida, S W Hetts, V V Halbach
INTRODUCTION/PURPOSE: To achieve aneurysm occlusion, flow diverters (FDs) must be accurately sized to maximize coverage over the neck and induce thrombosis. Catheterization for diagnostic angiography can cause vasospasm that may affect vessel measurements. This study evaluates impacts of intra-arterial infusion of a calcium channel blocker (CCB) on angiographic measurements in patients treated with FDs to determine effects on final diameter of the FD and subsequent occlusion. MATERIALS AND METHODS: Pre-treatment measurements were recorded for diameter of the distal and proximal landing zones and maximum and minimum diameters between these segments...
October 26, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27791519/safety-and-efficacy-of-the-pipeline-embolization-device-for-treatment-of-intracranial-aneurysms-a-pooled-analysis-of-3-large-studies
#6
David F Kallmes, Waleed Brinjikji, Saruhan Cekirge, David Fiorella, Ricardo A Hanel, Pascal Jabbour, Demetrius Lopes, Pedro Lylyk, Cameron G McDougall, Adnan Siddiqui
OBJECTIVE The authors performed a pooled analysis of 3 studies-IntrePED (International Retrospective Study of the Pipeline Embolization Device), PUFS (Pipeline for Uncoilable or Failed Aneurysms Study), and ASPIRe (Aneurysm Study of Pipeline in an Observational Registry)-in order to assess angiographic outcomes and clinical safety of the Pipeline embolization device (PED). METHODS IntrePED was a retrospective study, while PUFS and ASPIRe were prospective studies. For each patient included in these studies, the authors collected baseline demographic data, aneurysm characteristics, and procedural details...
October 28, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27770038/early-angiographic-signs-of-acute-thrombus-formation-following-cerebral-aneurysm-treatment-with-the-pipeline-embolization-device
#7
Akil Patel, Timothy R Miller, Ravi Shivashankar, Gaurav Jindal, Dheeraj Gandhi
BACKGROUND AND OBJECTIVE: Acute thrombus formation following aneurysm treatment with the Pipeline embolization device (PED) is a potentially devastating complication that may result in significant thromboembolic sequelae if not promptly treated. We therefore evaluated PED cases complicated by acute thrombus formation at our institution, with an emphasis on identifying early angiographic signs that may portend this event. MATERIALS AND METHODS: We retrospectively identified cases of acute thrombosis following PED placement in 100 consecutive procedures performed at our institution from a prospectively maintained clinical database...
October 21, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27739944/pipeline-for-uncoilable-or-failed-aneurysms-3-year-follow-up-results
#8
Tibor Becske, Matthew B Potts, Maksim Shapiro, David F Kallmes, Waleed Brinjikji, Isil Saatci, Cameron G McDougall, István Szikora, Giuseppe Lanzino, Christopher J Moran, Henry H Woo, Demetrius K Lopes, Aaron L Berez, Daniel J Cher, Adnan H Siddiqui, Elad I Levy, Felipe C Albuquerque, David J Fiorella, Zsolt Berentei, Miklós Marosföi, Saruhan H Cekirge, Peter K Nelson
OBJECTIVE The long-term effectiveness of endovascular treatment of large and giant wide-neck aneurysms using traditional endovascular techniques has been disappointing, with high recanalization and re-treatment rates. Flow diversion with the Pipeline Embolization Device (PED) has been recently used as a stand-alone therapy for complex aneurysms, showing significant improvement in effectiveness while demonstrating a similar safety profile to stent-supported coil treatment. However, relatively little is known about its long-term safety and effectiveness...
October 14, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27703060/quantitative-assessment-of-parent-vessel-and-distal-intracranial-hemodynamics-following-pipeline-flow-diversion
#9
Sophia F Shakur, Victor A Aletich, Sepideh Amin-Hanjani, Ahmed E Hussein, Fady T Charbel, Ali Alaraj
BACKGROUND: Pipeline embolization devices (PEDs) are commonly used for endovascular treatment of cerebral aneurysms but can be associated with delayed ipsilateral intraparenchymal hemorrhage. Although intra-aneurysmal hemodynamic changes have been studied, parent vessel and intracranial hemodynamics after PED use are unknown. We examine the impact of flow diversion on parent artery and distal intracranial hemodynamics. METHOD: Patients with internal carotid cerebral aneurysms treated with PED who had flow volume rate, flow velocities, pulsatility index, resistance index, Lindegaard ratio, and wall shear stress (WSS) obtained after treatment using quantitative magnetic resonance angiography were reviewed...
October 4, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27693822/flow-diversion-for-treatment-of-growing-a2-aneurysm-in-a-child-case-report-and-review-of-flow-diversion-for-intracranial-aneurysms-in-pediatric-patients
#10
Jay Ashok Vachhani, Christopher Michael Nickele, Lucas Elijovich, Paul Klimo, Adam Stephen Arthur
BACKGROUND: Intracranial flow diversion has gained increasing popularity since the approval of the Pipeline Embolization Device (PED). Although it is only approved for use in adult patients, the PED has been used to treat aneurysms in pediatric patients. We present the first reported case of the use of a PED in a pediatric patient to treat an unusual fusiform distal anterior cerebral artery aneurysm. CASE DESCRIPTION: A 12-year-old girl presented with new onset seizures and was found to have a distal left anterior cerebral artery aneurysm...
September 29, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27683754/use-of-aspirin-as-sole-oral-antiplatelet-therapy-in-acute-flow-diversion-for-ruptured-dissecting-aneurysms
#11
Albert Ho Yuen Chiu, Rajalakshmi Ramesh, Jason Wenderoth, Mark Davies, Andrew Cheung
Subarachnoid hemorrhage secondary to rupture of a circumferential dissecting aneurysm continues to be a treatment dilemma. Vessel sacrifice, when possible, continues to be the safest option but in certain cases this is not possible due to lack of collateral supply. In such cases, coil assisted endovascular flow diversion has become a potential option but the requirement for dual antiplatelet therapy in an unsecured intracranial aneurysm continues to raise concern.We present a 48-year-old man with a World Federation of Neurological Surgeons grade 5 subarachnoid hemorrhage, secondary to a ruptured intradural left vertebral artery dissecting aneurysm, who was treated successfully with a pipeline embolization device with Shield technology using aspirin and a single intravenous loading dose of abciximab...
September 28, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27651873/inadvertent-complication-of-a-pipeline-embolization-device-for-treatment-with-vertebral-artery-dissecting-aneurysm-distal-tip-fracture-of-delivery-wire
#12
Jung Soo Park, Hyo Sung Kwak, Jong Myong Lee
Use of the Pipeline embolization device (PED) has increased based on studies about its safety and effectiveness, and new reports that describe peri- or postprocedural complications are now emerging. We report a rare periprocedural device-related complication that occurred during endovascular treatment with the pipeline embolization device for a dissecting aneurysm on the vertebral artery. A 55-year old woman was admitted due to left medullary infarction, and angiography showed a fusiform dilatation in the left vertebral artery that was suspicious for dissecting aneurysm...
September 2016: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/27647130/evaluation-of-pipeline-flex-delivery-system-for-the-treatment-of-unruptured-aneurysms
#13
Pedro Aguilar-Salinas, Leonardo B C Brasiliense, Douglas Gonsales, Bartley Mitchell, Andrey Lima, Eric Sauvageau, Ricardo Hanel
Refinements in endovascular technology have revolutionized the treatment of intracranial aneurysms (IAs) with the development of flow-diversion technology. The first generation of the Pipelin Embolization Device (PED) has demonstrated its safety and efficacy. However, the deployment technique was a difficult task that often led to complex maneuvers. The Pipeline Flex Embolization Device (PED Flex) is the second generation and its introduction has arrived with high expectations due to a completely redesigned delivery system that intends to overcome deployment difficulties seen in the previous generation...
October 2016: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/27641263/assessment-of-dual-antiplatelet-regimen-for-pipeline-embolization-device-placement-a-survey-of-major-academic-neurovascular-centers-in-the-united-states
#14
Raghav Gupta, Justin M Moore, Christoph J Griessenauer, Nimer Adeeb, Apar S Patel, Roy Youn, Karen Poliskey, Ajith J Thomas, Christopher S Ogilvy
INTRODUCTION: Flow diversion with the Pipeline Embolization Device (PED) is currently adopted for treatment of a variety of intracranial aneurysms. The elevated risk of thromboembolic complications associated with the device necessitates the need for administration of antiplatelet agents. We sought to assess current dual antiplatelet therapy practices patterns and their associated costs, following PED placement. MATERIALS AND METHODS: An online questionnaire assessing dual antiplatelet regimens following flow diversion for treatment of intracranial aneurysms was developed and disseminated to 80 neurosurgeons at major academic cerebrovascular centers...
September 15, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27636182/aneurysms-with-persistent-patency-after-treatment-with-the-pipeline-embolization-device
#15
Peter Kan, Visish M Srinivasan, Nnenna Mbabuike, Rabih G Tawk, Vin Shen Ban, Babu G Welch, Maxim Mokin, Bartley D Mitchell, Ajit Puri, Mandy J Binning, Edward Duckworth
The Pipeline Embolization Device (PED) was approved for the treatment of intracranial aneurysms from the petrous to the superior hypophyseal segment of the internal carotid artery. However, since its approval, its use for treatment of intracranial aneurysms in other locations and non-sidewall aneurysms has grown tremendously. The authors report on a cohort of 15 patients with 16 cerebral aneurysms that incorporated an end vessel with no significant distal collaterals, which were treated with the PED. The cohort includes 7 posterior communicating artery aneurysms, 5 ophthalmic artery aneurysms, 1 superior cerebellar artery aneurysm, 1 anterior inferior cerebellar artery aneurysm, and 2 middle cerebral artery aneurysms...
September 16, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27610126/aneurysm-study-of-pipeline-in-an-observational-registry-aspire
#16
David F Kallmes, Waleed Brinjikji, Edoardo Boccardi, Elisa Ciceri, Orlando Diaz, Rabih Tawk, Henry Woo, Pascal Jabbour, Felipe Albuquerque, Rene Chapot, Alain Bonafe, Shervin R Dashti, Josser E Delgado Almandoz, Curtis Given, Michael E Kelly, DeWitte T Cross, Gary Duckwiler, Nasser Razack, Ciaran J Powers, Sebastian Fischer, Demetrius Lopes, Mark R Harrigan, Daniel Huddle, Raymond Turner, Osama O Zaidat, Luc Defreyne, Vitor Mendes Pereira, Saruhan Cekirge, David Fiorella, Ricardo A Hanel, Pedro Lylyk, Cameron McDougall, Adnan Siddiqui, Istvan Szikora, Elad Levy
BACKGROUND AND OBJECTIVE: Few prospective studies exist evaluating the safety and efficacy of the Pipeline Embolization Device (PED) in the treatment of intracranial aneurysms. The Aneurysm Study of Pipeline In an observational Registry (ASPIRe) study prospectively analyzed rates of complete aneurysm occlusion and neurologic adverse events following PED treatment of intracranial aneurysms. MATERIALS AND METHODS: We performed a multicenter study prospectively evaluating patients with unruptured intracranial aneurysms treated with PED...
June 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27599997/p2y12-hyporesponse-pru-200-is-not-associated-with-increased-thromboembolic-complications-in-anterior-circulation-pipeline
#17
Matthew T Bender, Li-Mei Lin, Geoffrey P Colby, Daniel Lubelski, Judy Huang, Rafael J Tamargo, Alexander L Coon
INTRODUCTION: Recent reports suggest that thromboembolic complications are associated with Pipeline embolization device (PED) placement cluster in P2Y12 hyporesponders. OBJECTIVE: To evaluate the role of P2Y12 hyporesponse in PED placement by retrospectively reviewing a single-center series of patients. METHODS: We retrospectively reviewed an institutional review board-approved database of patients with an aneurysm at a single institution and identified all patients with a measured P2Y12 reaction unit (PRU)>200 who had undergone anterior circulation PED placement...
September 6, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27596802/carotid-cavernous-fistula-after-pipeline-placement-a-single-center-experience-and-review-of-the-literature
#18
Anil K Roy, Jonathan A Grossberg, Joshua W Osbun, Susana L Skukalek, Brian M Howard, Faiz U Ahmad, Frank Tong, Jacques E Dion, Charles M Cawley
OBJECTIVE: Carotid cavernous fistula (CCF) development after Pipeline Embolization Device (PED) treatment of cavernous carotid aneurysms (CCA) can be a challenging pathology to treat for the neurointerventionalist. METHODS: A database of all patients whose aneurysms were treated with the PED since its approval by the Food and Drug Administration in 2011 was retrospectively reviewed. Demographic information, aneurysm characteristics, treatment technique, antiplatelet regimen, and follow-up data were collected...
September 5, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27565476/same-day-discharge-following-treatment-with-the-pipeline-embolization-device-using-monitored-anesthesia-care
#19
Mario Zanaty, Badih Daou, Nohra Chalouhi, Robert M Starke, Edgar Samaniego, Colin Derdeyn, Pascal Jabbour, David Hasan
OBJECTIVE: The Pipeline Embolization Device has been used shown safe under Monitored Anesthesia Care (MAC). We present the results of the first study assessing the safety and feasibility of same-day discharge in patients undergoing treatment with the PED, using MAC. METHODS: A total of 130 patients with 143 CAs were identified. Patients were treated under MAC with PED. All patients were counseled pre-operatively about the elective nature of the procedure and the same-day discharge...
August 23, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27530137/reliability-of-dual-vs-single-volume-reconstruction-of-three-dimensional-digital-subtraction-angiography-for-follow-up-evaluation-of-endovascularly-treated-intracranial-aneurysms
#20
Nimer Adeeb, Christoph J Griessenauer, Apar S Patel, Justin Moore, Parviz Dolati-Ardejani, Raghav Gupta, Rouzbeh Motiei-Langroudi, Christopher S Ogilvy, Ajith J Thomas
INTRODUCTION: Single-volume reconstruction of three-dimensional (3D) digital subtraction angiography (DSA) can be effectively used for aneurysm assessment and planning of endovascular embolization. Unfortunately, post-embolization follow-up angiographic images can be obscured by artifact. The dual-volume reconstruction technique was developed in order to reduce artifact and enhance the visualization of the aneurysm, the parent vessel and side branches, and endovascular devices. The purpose of this study was to compare the reliability of dual- vs single-volume reconstruction of 3D DSA in evaluation of follow-up images after endovascular embolization of intracranial aneurysms...
August 16, 2016: Interventional Neuroradiology
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