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Pipeline embolic device

Yupeng Zhang, Chao Ma, Shikai Liang, Peng Yan, Fei Liang, Feng Guo, Chuhan Jiang
OBJECTIVE: To explore whether computed morphological features can be used as independent predictors of incomplete occlusion of aneurysms treated with pipeline embolization device. METHODS: From January 2016 to September 2017, 58 patients with 58 aneurysms were treated with pipeline embolization device in our center. Aneurysms were manually segmented from the DICOM file and we calculated 16 shape features voxel by voxel on the segmented aneurysm image. Along with other 13 clinical and radiographic variables, we performed univariate and multivariate analysis to explore predictors of incomplete occlusion...
August 10, 2018: World Neurosurgery
Anna Luisa Kühn, Peter Kan, Visish Srinivasan, David E Rex, Katyucia de Macedo Rodrigues, Mary C Howk, Ajay K Wakhloo, Ajit S Puri
Background To evaluate the feasibility and efficacy of the pipeline embolization device in the treatment of unruptured intracranial mirror segment aneurysms. Methods Out of a total of 338 subjects, 14 were identified harboring a total of 32 internal carotid artery mirror segment aneurysms that were treated with the pipeline embolization device and were consecutively enrolled into our study. We collected data on patient demographics, modified Rankin scale (mRS) at admission, aneurysm characteristics, clinical outcome at discharge, 3-9 and at 12-18 months as well as angiography results at follow-up...
August 6, 2018: Interventional Neuroradiology
Christoph J Griessenauer, Oded Goren, Shamsher S Dalal, Clemens M Schirmer
BACKGROUND: Thromboembolic complications remain a major reason for morbidity and mortality after flow diversion along with hemorrhagic complications not limited to the brain predicated on the prolonged need for dual antiplatelet therapy. Surface modification to decrease thrombogenicity and accelerate aneurysm occlusion is a promising alteration to mitigate those risks. The Pipeline embolization device (PED) with Shield technology possesses such characteristics, but is currently not approved in the United States...
July 31, 2018: World Neurosurgery
Timothy Hampton, Donal Walsh, Christos Tolias, David Fiorella
BACKGROUND: Flow-diverting stents have demonstrated great promise for the treatment of cerebral aneurysms; however, clinical experience with the devices remains very preliminary. We present two cases of spontaneous delayed complications-one fatal aneurysm rupture and one symptomatic increase in aneurysm volume-following the treatment of intradural aneurysms with the Pipeline Embolization Device (PED). PRESENTATION/INTERVENTION: Two patients with unruptured, intradural aneurysms of the carotid artery underwent uneventful treatment with the PED (eV3, Irvine, California, USA)...
July 2018: Journal of Neurointerventional Surgery
D Fiorella, P Lylyk, I Szikora, M E Kelly, F C Albuquerque, C G McDougall, P K Nelson
Endovascular, endosaccular, coil embolization has emerged as an established therapy for both ruptured and unruptured cerebral aneurysms. However, many aneurysms are not cured using conventional endovascular techniques. Coil embolization often results in incomplete aneurysm occlusion or recanalization in the ensuing months after treatment. The Pipeline embolization device (PED; Chestnut Medical) represents a new generation endoluminal implant which is designed to treat aneurysms by reconstructing the diseased parent artery...
July 2018: Journal of Neurointerventional Surgery
Christophe Cognard
No abstract text is available yet for this article.
July 2018: Journal of Neurointerventional Surgery
Wesley K Lefferts, Kevin S Heffernan
No abstract text is available yet for this article.
January 1, 2018: Interventional Neuroradiology
Y K He, H Li, W X Bai, T X Li, W J Jiang, H C Qiu
Objective: To summarize the safety and efficacy of Pipeline embolization device in the treatment of large and giant intracranial aneurysms (maximum diameter ≥ 10 mm). Methods: The clinical and imaging data of 22 patients with intracranial aneurysms treated by Pipeline Embolization Device (PED) from February 2015 to July 2016 in the Zhengzhou University People's Hospital were retrospectively analyzed. The results about postoperative clinical and imaging follow-up and complications were evaluated. Results: The PED were successfully implanted in 22 patients with 22 intracranial aneurysms...
July 17, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Krishnan Ravindran, Marcello DiStasio, Roger Laham, Christopher S Ogilvy, Ajith J Thomas, Paul A VanderLaan, Abdulrahman Y Alturki
BACKGROUND: Endothelial cell coverage along the Pipeline embolization device (PED) is one of two primary proposed mechanisms of action of the device, along with induction of intra-aneurysmal thrombosis. The temporal course of endothelialization following device deployment is poorly understood in human patients. CASE DESCRIPTION: Here, the authors present a case of a 63-year-old female with a persistent aneurysm in the communicating segment of the internal carotid artery treated with a second PED, 14 months after the deployment of a 1st PED, who subsequently developed a fatal intraparenchymal hemorrhage 3 weeks post-implantation...
July 18, 2018: World Neurosurgery
Krishnan Ravindran, Alejandro Enriquez-Marulanda, Peter T M Kan, Leonardo Renieri, Nicola Limbucci, Salvatore Mangiafico, Mohamed M Salem, Abdulrahman Y Alturki, Justin M Moore, Christopher S Ogilvy, Ajith J Thomas
OBJECTIVE: The safety and efficacy of flow diversion for distal circulation aneurysms of the cerebral vasculature has not been well-evaluated. The objective of this study was to assess the use of flow diversion for distal circulation aneurysms - defined as at or beyond the M1, P1 and A1 segments of the MCA, PCA and ACA, respectively -in an international, multi-center cohort. METHODS: Clinical and radiological records from all patients undergoing flow diversion treatment of distal circulation aneurysms at 3 academic centers (2 US, 1 Europe) from 2014 until 2017 were retrospectively reviewed...
July 16, 2018: World Neurosurgery
Raghav Gupta, Christopher S Ogilvy, Justin M Moore, Christoph J Griessenauer, Alejandro Enriquez-Marulanda, Madeline Leadon, Nimer Adeeb, Luis Ascanio, Georgios A Maragkos, Abhi Jain, Philip G R Schmalz, Abdulrahman Y Alturki, Kimberly Kicielinski, Clemens M Schirmer, Ajith J Thomas
OBJECTIVE There is currently no standardized follow-up imaging strategy for intracranial aneurysms treated with the Pipeline embolization device (PED). Here, the authors use follow-up imaging data for aneurysms treated with the PED to propose a standardizable follow-up imaging strategy. METHODS A retrospective review of all patients who underwent treatment for ruptured or unruptured intracranial aneurysms with the PED between March 2013 and March 2017 at 2 major academic institutions in the US was performed...
July 13, 2018: Journal of Neurosurgery
Ryuta Nakae, Masaya Nagaishi, Yosuke Kawamura, Yoshihiro Tanaka, Akio Hyodo, Kensuke Suzuki
OBJECTIVE The authors sought to demonstrate that hemorrhagic transformation of ischemic lesions is the main cause of delayed intracerebral hemorrhage (ICH) after Pipeline embolization device (PED) treatment and to estimate the rate of hemorrhagic transformation of new postprocedure ischemic lesions. METHODS Patients who underwent PED placement (PED group) from November 2015 to March 2017 or stent-mediated embolization (EN group) from December 2010 to October 2015 were retrospectively analyzed. Pre- and postprocedural MR images and 6-month follow-up MR images for each patient were scored for the presence of postprocedural bland ischemic and hemorrhagic lesions using diffusion-weighted MRI (DWI) and T2*-weighted MRI (T2*WI), respectively...
June 1, 2018: Journal of Neurosurgery
Jan-Karl Burkhardt, Howard A Riina, Omar Tanweer, Peyman Shirani, Eytan Raz, Maksim Shapiro, Peter Kim Nelson
The authors present the unusual case of a complex unruptured basilar artery terminus (BAT) aneurysm in a 42-year-old symptomatic female patient presenting with symptoms of mass effect. Due to the fusiform incorporation of both the BAT and left superior cerebellar artery (SCA) origin, simple surgical or endovascular treatment options were not feasible in this case. A 2-staged (combined deconstructive/reconstructive) procedure was successfully performed: first occluding the left SCA with a Pipeline embolization device (PED) coupled to a microvascular plug (MVP) in the absence of antiplatelet coverage, followed by reconstruction of the BAT by deploying a second PED from the right SCA into the basilar trunk...
June 29, 2018: Journal of Neurosurgery
Michael A Silva, Alfred P See, Priyank Khandelwal, Ashutosh Mahapatra, Kai U Frerichs, Rose Du, Nirav J Patel, Mohammad A Aziz-Sultan
OBJECTIVE Paraclinoid aneurysms represent approximately 5% of intracranial aneurysms (Drake et al. [1968]). Visual impairment, which occurs in 16%-40% of patients, is among the most common presentations of these aneurysms (Day [1990], Lai and Morgan [2013], Sahlein et al. [2015], and Silva et al. [2017]). Flow-diverting stents, such as the Pipeline Embolization Device (PED), are increasingly used to treat these aneurysms, in part because of their theoretical reduction of mass effect (Fiorella et al. [2009])...
June 22, 2018: Journal of Neurosurgery
Murillo Cunegatto-Braga, Brian Hogan, Pedro Aguilar-Salinas, Alexandra D Beier, Ricardo A Hanel
BACKGROUND: Intracranial aneurysms(IAs) are rare in the pediatric population and are usually considered difficult to treat with traditional microsurgery due to their complex morphology. Endovascular techniques have become the standard option for treating IAs in adults. More recently, flow diverters such as the Pipeline Embolization Device(PED) are being widely adopted for unruptured IAs with safety and efficacy in adults, yet their use in the pediatric population is not well defined. In this paper we present a pediatric patient with a ruptured PCA aneurysm successfully treated with a PED and a review of the literature of the current status of PED use in this subset of patients...
June 14, 2018: World Neurosurgery
S V Setlur Nagesh, A Shankar, J Krebs, J Hinaman, D R Bednarek, S Rudin
Real-time visualization of fine details ranging to 100 um or less in neuro-vascular imaging guided interventions is important. A separate high-resolution detector mounted on a standard flat panel detector (FPD) was previously reported. This device had to be rotated mechanically into position over the FPD for high resolution imaging. Now, the new detector reported here has a high definition (Hi-Def) zoom capability along with the FPD built into one unified housing. The new detector enables rapid switching, by the operator between Hi-Def and FPD modes...
February 2018: Proceedings of SPIE
N Adeeb, C J Griessenauer, A A Dmytriw, H Shallwani, R Gupta, P M Foreman, H Shakir, J Moore, N Limbucci, S Mangiafico, A Kumar, C Michelozzi, Y Zhang, V M Pereira, C C Matouk, M R Harrigan, A H Siddiqui, E I Levy, L Renieri, T R Marotta, C Cognard, C S Ogilvy, A J Thomas
BACKGROUND AND PURPOSE: Flow diversion with the Pipeline Embolization Device is increasingly used for endovascular treatment of intracranial aneurysms due to high reported obliteration rates and low associated morbidity. While obliteration of covered branches in the anterior circulation is generally asymptomatic, this has not been studied within the posterior circulation. The aim of this study was to evaluate the association between branch coverage and occlusion, as well as associated ischemic events in a cohort of patients with posterior circulation aneurysms treated with the Pipeline Embolization Device...
July 2018: AJNR. American Journal of Neuroradiology
M Akli Zetchi, Adam A Dmytriw, Albert H Chiu, Brian J Drake, Niki V Alizadeh, Aditya Bharatha, Abhaya V Kulkarni, Thomas R Marotta
Objective Numerous studies have suggested a relationship between delayed occlusion of intracranial aneurysms treated with the Pipeline Embolization Device (PED) and the presence of an incorporated branch. However, in some cases, flow diversion may still be the preferred treatment option. This study sought to determine whether geometric factors pertaining to relative size and angulation of branch vessel(s) can be measured in a reliable fashion and whether they are related to occlusion rates. Methods Eighty aneurysms treated at a single neurovascular center from November 2008 to June 2014 were identified...
January 1, 2018: Interventional Neuroradiology
Ryuta Nakae, Tomoji Takigawa, Koji Hirata, Masaya Nagaishi, Akio Hyodo, Kensuke Suzuki
BACKGROUND: Inflow into an aneurysm sac immediately following flow diverter (FD) treatment is an assumed cause of delayed aneurysmal rupture. The significance of delayed post-treatment residual flow occurring months after FD treatment is unknown. CASE DESCRIPTION: A 76-year-old woman with a large intracranial aneurysm measuring 23.0 × 18.1 mm in the cavernous segment of the right internal carotid artery was treated with placement of a single FD (Pipeline Embolization Device [PED]®, Covidien, Irvine, CA, USA)...
May 28, 2018: World Neurosurgery
Volker Maus, Anastasios Mpotsaris, Jan Borggrefe, Nuran Abdullayev, Thomas Liebig, Franziska Dorn, Pantelis Stavrinou, De-Hua Chang, Christoph Kabbasch
No abstract text is available yet for this article.
May 30, 2018: Neurointervention
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