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Vascular neurology
Parent artery occlusion after pipeline embolization device implantation of intracranial saccular and fusiform aneurysms
  1. Mingyang Han1,
  2. Xin Tong2,
  3. Zhifei Wang1,
  4. Aihua Liu2
  1. 1Department of Neurosurgery, Central South University Third Xiangya Hospital, Changsha, Hunan, China
  2. 2Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
  1. Correspondence to Professor Aihua Liu, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; liuaihuadoctor{at}163.com; Professor Zhifei Wang, Department of Neurosurgery, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China; doctorwangzhifei{at}163.com

Abstract

Background Studies reporting parent artery occlusion (PAO) after pipeline embolization device (PED) implantation are limited. The aim of this study was to investigate the incidence rate and risk factors of PAO after PED implantation.

Methods In this retrospective study, we enrolled consecutive patients with intracranial saccular and fusiform aneurysms treated with PED implantation at our institution. Multivariate logistic regression analysis was subsequently performed to determine the risk factors for PAO.

Results A total of 588 saccular and fusiform aneurysms were finally enrolled in the study. PAO was found in 14 (2.38%) aneurysms. The aneurysm complete occlusion rate was 79.6%. Compared with the non-PAO group, aneurysms in the PAO group were larger in size (20.08 vs 9.61 mm; p<0.001), had a greater neck diameter (9.92 vs 6.15 mm; p=0.001), and had higher frequencies of adjunctive coils (64.3% vs 35.7%; p=0.028). In the multivariate logistic analysis, aneurysm size (OR 1.12, 95% CI 1.02 to 1.24; p=0.016) and the presence of poor wall apposition after balloon angioplasty (OR 7.74, 95% CI 1.28 to 46.82; p=0.026) were associated with PAO occurrence after adjusting for confounding factors.

Conclusions In this study, the incidence rate of PAO following PED implantation was 2.38% in intracranial saccular and fusiform aneurysms. Aneurysm size and residual presence of poor wall apposition after balloon angioplasty were risk factors for PAO. Further research is required to better understand the mechanisms of PAO.

  • Aneurysm
  • Stent
  • Brain
  • Complication

Data availability statement

Data are available upon reasonable request.

https://doi.org/10.1136/jnis-2022-019273

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • MH and XT contributed equally.

    • ZW and AL contributed equally.

    • Contributors Conception and design: MH, XT, ZW, and AL. Acquisition of the data, data curation and analysis, drafting of the article, and interpretation of the data: MH and XT. Critical revision: all authors. ZW and AL are responsible for ensuring that the descriptions are accurate and agreed by all authors. AL and ZW accept full responsibility for the work and/or the conduct of the study, had access to the data, and controlled the decision to publish.

    • Competing interests None declared.

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

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.