Introduction The introduction of the Pipeline Embolization Device (PED, eV3 Neurovascular, Irvine, California) has increased the complexity of the cerebral aneurysms which can be treated with neuro-interventional techniques. We sought to compare the recurrence rates following PED alone versus PED and coil embolization (PED/coil) of intracranial cerebral aneurysms in our single center.

Materials and Methods We retrospectively examined a prospectively maintained endovascular database for cerebral aneurysms treated with the PED with or without coils from May 2011 to the present time. One hundred and thirty three patients (25 males, 108 females; age range 23–85 years; average 60.4 yrs) were treated for 140 aneurysms (average size 11.8 mm, SD 8.3 mm) requiring 224 PED (1.7 PED/pt) during the study period. Sixty-eight patients (13 males, 55 females) were treated with PED alone for 72 aneurysms (average 10.7mm, SD 9.2 mm). Whereas, 65 patients (12 males, 53 females) were treated with PED/coil of 67 aneurysms (average 12.8 mm, SD 7.0 mm)

Results Eight aneurysms in eight patients were re-treated in the PED alone cohort versus only one aneurysm in one patient in the PED/coil cohort for an 11.7% (8/68) versus 1.5% (1/65) re-treatment rate respectively. The average time for re-treatment in the PED alone cohort was 6.5 months (SD 3.8) while the PED/coil re-treatment occurred at 10 months. Two patients in the PED cohort were re-treated due to PED contraction/migration while the other six patients were re-treated for enlargement or persistent filling of the aneurysms. The PED/coil patient had significant improvement in the aneurysm filling, but had small persistent endoleak into the aneurysm.

Conclusions In our single center experience, PED/coil of cerebral aneurysms resulted in a lower re-treatment rate compared to PED alone. This result may provide the basis for future evaluation with randomised, controlled trials.

Disclosures M. Park: None. M. Nanaszko: None. M. Sanborn: None. K. Moon: None. F. Albuquerque: None. C. McDougall: None.