PT  - JOURNAL ARTICLE
AU  - Geoffrey P Colby
AU  - Li-Mei Lin
AU  - Neelesh Nundkumar
AU  - Bowen Jiang
AU  - Judy Huang
AU  - Rafael J Tamargo
AU  - Alexander L Coon
TI  - Radiation dose analysis of large and giant internal carotid artery aneurysm treatment with the pipeline embolization device versus traditional coiling techniques
AID  - 10.1136/neurintsurg-2014-011193
DP  - 2015 May 01
TA  - Journal of NeuroInterventional Surgery
PG  - 380--384
VI  - 7
IP  - 5
4099  - http://jnis.bmj.com/content/7/5/380.short
4100  - http://jnis.bmj.com/content/7/5/380.full
SO  - J NeuroIntervent Surg2015 May 01; 7
AB  - Background Flow diversion is an effective and increasingly accepted method for endovascular treatment of cerebral aneurysms. Additionally, the public has heightened concerns regarding radiation exposure from medical procedures. This study analyzes radiation dose and fluoroscopy time during treatment of large and giant proximal internal carotid artery (ICA) aneurysms with the pipeline embolization device (PED) versus traditional coiling techniques. Methods Radiation dose, fluoroscopy time, and contrast dye administration were retrospectively analyzed in 55 patients undergoing endovascular treatment of aneurysms ≥10 mm from petrous to superior hypophyseal ICA segments. Patients were treated by either PED (37 patients) or traditional coiling techniques (18 patients). Aortic arch type and proximal ICA tortuosity were also assessed as markers of access difficulty. Results Average radiation dose with PED treatment was 2840±213 mGy and 4010±708 mGy with traditional coiling techniques (p=0.048; 29% decrease with PED). Mean fluoroscopy time for PED was 56.1±5.0 min and 85.9±11.9 min for coiling cases (p=0.0087; 35% decrease with PED). These benefits existed despite more difficult arch anatomy and a trend towards greater proximal vessel tortuosity in PED cases. Contrast dye amounts were also reduced by 37.5% in PED cases (75±6 mL) versus coiling cases (120±13 mL, p=0.0008). Conclusions Treatment of large and giant proximal ICA aneurysms using PED requires less radiation, less fluoroscopy time, and less contrast administration than standard coiling techniques. This further demonstrates the benefits of flow diversion for treatment of these aneurysms.