Aims and Objectives The Pipeline Embolisation Device (PED) was recently approved in the United States (US) for the treatment of wide-necked anterior circulation aneurysms. Studies in both the US and Europe have confirmed its efficacy as well as an acceptable complication rate associated with its use. In this setting, we sought to analyse our results prospectively in the first 100 patients treated at our institution since FDA approval of the device in May of 2011.
Materials and Methods We analysed all patients treated with the PED, specifically assessing the following factors: patient demographics, number of devices used, aneurysm location, clinical/angiographic follow-up, rate of obliteration, number of residual aneurysms, and complications.
Results and Discussion 100 patients with 115 aneurysms were treated with the PED. Of these, there were 19 men and 81 women ranging in age from 23 to 83 years (mean = 59.2 years). A total of 185 PEDs were used with an average of 1.85 per patient. Aneurysm locations were myriad with the peri-ophthalmic and cavernous segments comprising the largest proportion (35 and 33 aneurysms respectively). Fourteen posterior circulation aneurysms were treated in this cohort. Radiographic follow-up was obtained in 68 patients at an average of 6.6 months after treatment. Of these, 45 patients demonstrated complete obliteration of their aneurysms and 12 patients near-complete (< 90%). The rate of complete and near-complete obliteration was 83.8%. A total of 20 complications occurred with 3 of these being permanent and 17 transient. The 3 permanent complications included 2 deaths and 1 stroke. Patient compliance with and/or tolerance of anti-platelet therapy was a major factor accounting for complications. The overall rate of permanent complications was 3%.
Conclusions The PED is a safe and effective means of treating complex cerebral aneurysms. Nonetheless, a number of technical factors and patient compliance issues complicate its use.
Disclosures F. Albuquerque: None. A. Ducruet: None. W. Crowley: None. C. McDougall: None.
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