Introduction/Purpose Flow-diverter devices have revolutionized the treatment of intracranial aneurysms since their approval in 2011 and have continued to evolve. The devices have been widely adopted across institutions and centers over the past decade, however long-term follow-up after treatment with Pipeline Embolization Device is not well described in the literature. Our institution is among the first to begin utilizing PEDs, allowing us to report our series of patients treated with flow diverters with at least 10 years of follow-up. In this study, we aimed to evaluate the long-term angiographic and clinical outcomes of patients with wide neck aneurysms treated with PED and review lessons learned along the way.

Materials and Methods We performed a retrospective review of our institution’s intracranial aneurysm (IA) database from January 2007 - July 2012. All patients with IAs treated with a PED device prior to July 2012 were included.

Results A total of 83 patients with 92 aneurysms treated with PED were identified and included in the study. Mean aneurysm dome diameter was 9.2 mm (± SD 5.7), mean aneurysm height was 10.4 mm (± SD 6.8), and mean neck width was 4.1 mm (± SD 2.4). Only one (1.1%) aneurysm was ruptured at presentation. Eight (8.7%) aneurysms were recurrences of previous treatment modalities. Seventy-five (81.5%) aneurysms were in the ICA, 12 (13%) were vertebrobasilar, 3 (3.3%) were in the MCA and 2 (2.2%) were in the PCA. Of the patients with 10 years of follow-up, 15 (100%) were occluded, 1 (6.7%) was retreated, and none (0%) had in-stent stenosis (table 1).

Conclusions We provide our single institution series of flow diversion treatments of intracranial aneurysms with the first report of 10-year long-term follow-up clinical and angiographic outcomes. Flow diversion is an effective treatment for wide neck aneurysms with reliable long-term aneurysm occlusion and clinical outcomes.

Disclosures A. Monteiro: None. J. Lim: None. M. Siddiqi: None. B. Donnelly: None. W. Khawar: None. A. Baig: None. R. Turner: None. M. Bouslama: None. K. Raygor: None. P. Lai: None. S. Housley: None. J. Davies: 1; C; NIH NINDS, NSF SBIR. 2; C; Medtronic; Honoraria. 4; C; Synchron, Cerebrotech, QAS.ai, RIST. K. Snyder: 2; C; Boston Scientific, Canon Medical Systems USA, Inc., MicroVention, Medtronic, Stryker Neurovascular. 4; C; Boston Scientific, Access Closure Inc, Niagara Gorge Medical. A. Siddiqui: 2; C; Amnis Therapeutics, Apellis Pharmaceuticals, Inc., Boston Scientific, Canon Medical Systems USA, Inc., Cardinal Health 200, LLC, Cerebrotech Medical Systems, Inc., and others. 4; C; Adona Medical, Inc., Amnis Therapeutics, Bend IT Technologies, Ltd., BlinkTBI, Inc, Buffalo Technology Partners, Inc., Cardinal Consultants, LLC, Cerebrotech Medical Systems, Inc, and others. 6; C; National PI/Steering Committees: Cerenovus EXCELLENT and ARISE II Trial; Medtronic SWIFT PRIME, VANTAGE, EMBOLISE and SWIFT DIRECT Trials, and others. E. Levy: 2; C; Claret Medical, GLG Consulting, Guidepoint Global, Imperial Care, Medtronic, Rebound, StimMed, Misionix, Mosiac, Clarion, IRRAS.. 4; C; NeXtGen Biologics, RAPID Medical, Claret Medical, Cognition Medical, Imperative Care, Rebound Therapeutics, StimMed, Three Rivers Medical.