Background and Purpose The optimal treatment of intracranial dissecting aneurysms is a challenging issue. In the present study we report our experience using Pipeline Embolization Device for the treatment of such lesions.

Methods We retrospectively reviewed our institutional prospectively maintained Pipeline database to identify patient treated with this device for a cerebral dissecting aneurysm. The clinical, procedural and radiological data were reviewed.

Results Between July 2009 and December 2010 seven patients (4F/3M, mean age 48 years) underwent endovascular treatment of cerebral dissecting aneurysms with the Pipeline Embolization Device. In two cases the procedure was performed in the setting of acute or subacute subarachnoid hemorrhage. In 2 cases the Pipeline Embolization device was used for the retreatment of a previous unsuccessful stenting and coiling procedures. Three lesions were located in the posterior circulation and four in the anterior circulation. Optimal deployment of the Pipeline Embolization Device was achieved in all patients. No periprocedural complications were reported. One ischemic stroke, with permanent morbidity, was recorded 14 days after the procedure in a patient who did not comply with their antiplatelet therapy. Midterm follow-up results (average 9.8 months) including angiography or MR examinations, were available for six patient and demonstrated complete resolution of the aneurysm in all patient. All six patients demonstrated with an mRS=0 at follow-up.

Conclusion The Pipeline Embolization Device achieved optimal clinical and radiological results in six out of seven patients with a cerebral dissecting aneurysm. This device represents a promising option in the treatment of these challenging lesions.