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- Title
Long-term outcomes following pipeline embolization of unruptured aneurysms.
- Authors
Naylor, Ryan M.; Abbasi, Mehdi; Brinjikji, Waleed; Cloft, Harry J.; Kallmes, David F.; Lanzino, Giuseppe
- Abstract
Background: Flow diversion using the pipeline embolization device (PED) for unruptured aneurysms is associated with high occlusion and low morbidity and mortality. However, most reports have limited follow-up of 1–2 years. Therefore, we sought to report our outcomes after PED for unruptured aneurysms in patients with at least 5-years of follow-up. Methods: Review of patients undergoing PED for unruptured aneurysms from 2009 to 2016. Results: Overall, 135 patients with 138 aneurysms were included for analysis. Seventy-eight percent of aneurysms (n=107) over a median radiographic follow-up of 5.0 years underwent complete occlusion. Among aneurysms with at least 5-years of radiographic follow-up (n=71), 79% (n=56) achieved complete obliteration. No aneurysm recanalized after radiographic obliteration. Furthermore, over a median clinical follow-up period of 4.9 years, 84% of patients (n=115) self-reported mRS scores between 0 and 2. For patients with at least 5-years of clinical follow-up, 88% (n=61) reported mRS between 0 and 2. In total, 3% (n=4) of patients experienced a major, non-fatal neurologic complication related to the PED, 5% (n=7) of patients experienced a minor neurologic complication related to PED placement, and 2% (n=3) died from either delayed aneurysm rupture, delayed ipsilateral hemorrhage after PED placement, or delayed (9 months after treatment) neural compression after progressive thrombosis of a PED-treated dolichoectactic vertebrobasilar aneurysm. Conclusions: Treatment of unruptured aneurysms with the PED is associated with high rates of long-term angiographic occlusion and low, albeit clinically important, rates of major neurologic morbidity and mortality. Thus, flow diversion via PED placement is safe, effective, and durable.
- Subjects
ANEURYSMS; THERAPEUTIC embolization; ANGIOGRAPHY; CEREBRAL arteriovenous malformations; THROMBOSIS
- Publication
Acta Neurochirurgica, 2023, Vol 165, Issue 7, p1891
- ISSN
0001-6268
- Publication type
Article
- DOI
10.1007/s00701-023-05619-1