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New devices
Case series
Incidence of delivery wire recapture failure with the Pipeline Flex device
  1. Michael A Mooney1,
  2. Karam Moon1,
  3. Bradley A Gross2,
  4. Andrew F Ducruet1,
  5. Felipe C Albuquerque1
  1. 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
  2. 2Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
  1. Correspondence to Dr Felipe C Albuquerque, Department of Neurosurgery, Barrow Neurological Institute, St Joseph's Hospital and Medical Center, 350 W. Thomas Rd, Phoenix, AZ 85013, USA; Neuropub{at}dignityhealth.org

Abstract

Background The Pipeline Flex embolization device has several advantages over the first-generation Pipeline embolization device (Covidien, Dublin, Republic of Ireland). Despite these advantages, we have observed frequent difficulty in recapturing the device's delivery wire.

Objective To prospectively document the incidence of failure to recapture the delivery wire.

Methods We tracked our experience in patients undergoing endovascular treatment with a flow-diverting stent for cerebral aneurysms between 1 May and 30 September 2016. Patient and lesion characteristics, device dimensions, and technical outcomes of delivery wire recapture were prospectively recorded for each device.

Results Eighteen devices were deployed in 15 patients by the senior author (FCA) during this period. Failure to recapture the delivery wire occurred in 10 of 18 (56%) cases. No adverse outcomes of delivery wire recapture failure were encountered in this series.

Conclusions The incidence of delivery wire recapture failure with the Pipeline Flex device is high. Failure to recapture the delivery wire carries a theoretical risk of stent displacement when re-navigating across the device, and endovascular surgeons should be aware of this limitation. Authors are encouraged to report delivery wire recapture failure rates in future clinical series in which the Pipeline Flex device is used.

  • Aneurysm
  • Flow Diverter
  • guidewire
  • Stent

https://doi.org/10.1136/neurintsurg-2016-012856

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    Footnotes

    • Contributors MAM: conception, data collection, preparation of manuscript. KM: conception, data collection, revision of manuscript. BAG: conception, data collection. AFD: data collection, revision of manuscript. FCA: conception, data collection, preparation and revision of manuscript.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.