PT - JOURNAL ARTICLE AU - Kühn, Anna Luisa AU - de Macedo Rodrigues, Katyucia AU - Lozano, J Diego AU - Rex, David E AU - Massari, Francesco AU - Tamura, Takamitsu AU - Howk, Mary AU - Brooks, Christopher AU - L'Heureux, Jenna AU - Gounis, Matthew J AU - Wakhloo, Ajay K AU - Puri, Ajit S TI - Use of the Pipeline embolization device for recurrent and residual cerebral aneurysms: a safety and efficacy analysis with short-term follow-up AID - 10.1136/neurintsurg-2016-012772 DP - 2017 Dec 01 TA - Journal of NeuroInterventional Surgery PG - 1208--1213 VI - 9 IP - 12 4099 - http://jnis.bmj.com/content/9/12/1208.short 4100 - http://jnis.bmj.com/content/9/12/1208.full SO - J NeuroIntervent Surg2017 Dec 01; 9 AB - Objective Evaluation of the safety and efficacy of the Pipeline embolization device (PED) when used as second-line treatment for recurrent or residual, pretreated ruptured and unruptured intracranial aneurysms (IAs).Methods Retrospective review of our database to include all patients who were treated with a PED for recurrent or residual IAs following surgical clipping or coiling. We evaluated neurological outcome and angiograms at discharge, 6- and 12-months’ follow-up and assessed intimal hyperplasia at follow-up.Results Twenty-four patients met our inclusion criteria. Most IAs were located in the anterior circulation (n=21). No change of preprocedure modified Rankin Scale score was seen at discharge or at any scheduled follow-up. Complete or near-complete aneurysm occlusion on 6- and 12-month angiograms was seen in 94.4% (17/18 cases) and 93.3% (14/15 cases), respectively. Complete or near-complete occlusion was seen in 100% of previously ruptured and 85.7% (6/7 cases) and 83.3% (5/6 cases) of previously unruptured cases at the 6- and 12-months’ follow-up, respectively. One case of moderate intimal hyperplasia was observed at 6 months and decreased to mild at the 12-months’ follow-up. No difference in device performance was observed among pretreated unruptured or ruptured IAs.Conclusions Treatment of recurrent or residual IAs with a PED after previous coiling or clipping is feasible and safe. There is no difference in device performance between ruptured or unruptured IAs.