Document Detail


Treatment of intracranial aneurysms by functional reconstruction of the parent artery: the Budapest experience with the pipeline embolization device.
MedLine Citation:
PMID:  20150304     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Aneurysm treatment by intrasaccular packing has been associated with a relatively high rate of recurrence. The use of mesh tubes has recently gained traction as an alternative therapy. This article summarizes the midterm results of using an endoluminal sleeve, the PED, in the treatment of aneurysms. MATERIALS AND METHODS: A total of 19 wide-neck aneurysms were treated in 18 patients: 10 by implantation of PEDs alone and 9 by a combination of PED and coils. Angiographic and clinical results were recorded immediately and at 6 months following treatment. RESULTS: Immediate angiographic occlusion was achieved in 4 and flow reduction, in another 15 aneurysms. Angiography at 6 months demonstrated complete occlusion in 17 and partial filling in 1 of 18 patients. There was no difference between coil-packed and unpacked aneurysms. Of 28 side branches covered by > or =1 device, the ophthalmic artery was absent immediately in 1 and at 6 months in another 2 cases. One patient experienced abrupt in-stent thrombosis resulting in a transient neurologic deficit, and 1 patient died due to rupture of a coexisting aneurysm. All giant aneurysms treated with PED alone were demonstrated by follow-up cross-sectional imaging to have involuted by 6 months. CONCLUSIONS: Treatment of large, wide-neck, or otherwise untreatable aneurysms with functional reconstruction of the parent artery may be achieved with relative safety using dedicated flow-modifying devices with or without adjunctive use of intrasaccular coil packing.
Authors:
I Szikora; Z Berentei; Z Kulcsar; M Marosfoi; Z S Vajda; W Lee; A Berez; P K Nelson
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2010-02-11
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  31     ISSN:  1936-959X     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-14     Completed Date:  2010-09-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1139-47     Citation Subset:  IM    
Affiliation:
Department of Neuroradiology, National Institute of Neurosurgery, Amerikai ut 57, Budapest, Hungary. h13424szi@ella.hu
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MeSH Terms
Descriptor/Qualifier:
Carotid Artery Diseases / radiography,  therapy*
Carotid Artery, Internal / radiography
Cavernous Sinus / radiography
Cerebral Angiography
Cerebrovascular Circulation
Cobalt
Embolization, Therapeutic / instrumentation*,  methods*
Follow-Up Studies
Humans
Hungary
Intracranial Aneurysm / radiography,  therapy*
Nickel
Ophthalmic Artery / radiography
Platinum
Stents*
Surgical Mesh
Treatment Outcome
Chemical
Reg. No./Substance:
7440-02-0/Nickel; 7440-06-4/Platinum; 7440-48-4/Cobalt

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