Document Detail

Delayed Migration of a Pipeline Embolization Device.
MedLine Citation:
PMID:  23190638     Owner:  NLM     Status:  Publisher    
BACKGROUND:: Giant and complex aneurysms are increasingly treated with the Pipeline Embolization Device (PED). However, clinical experience with the device remains preliminary. OBJECTIVE:: To report the first case of a delayed migration of an intracranial PED. METHODS:: A 61-year-old woman with a known large right cavernous internal carotid artery aneurysm had a 3-month history of increasing retro-orbital pain. She underwent uneventful treatment of her aneurysm with the PED. RESULTS:: Five months after the procedure, the patient's pain recurred. On the routine 6-month follow-up angiography, there was proximal PED migration, with the distal end of the device projecting directly into the aneurysm and creating a jet of contrast against the aneurysm sac. The migration distance was more than 1 cm, and there was significant foreshortening of the device. A second, overlapping PED was successfully deployed within the first PED to bridge the neck of the aneurysm and redirect the flow jet away from the aneurysm sac. Complete resolution of the patient's symptoms was noted 4 weeks later. CONCLUSION:: Delayed proximal migration may occur after placement of a PED. Accurate stent sizing and adequate apposition to the vessel wall may minimize the occurrence of this undesirable phenomenon. If there is any concern regarding the position of the PED, early imaging follow-up may be indicated.
Nohra Chalouhi; Sudhakar R Satti; Stavropoula Tjoumakaris; Aaron S Dumont; L Fernando Gonzalez; Robert Rosenwasser; Pascal Jabbour
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-27
Journal Detail:
Title:  Neurosurgery     Volume:  -     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA *Department of Neurointerventional Surgery, Christiana Hospital, Delaware, USA.
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