Predictors of perioperative thromboembolic and hemorrhagic complications after treatment of cerebral aneurysms with the Pipeline Embolization Device (PED)
| All complications, % | p Value* | Major complications†, % | p Value* | |
|---|---|---|---|---|
| Sex | 0.67 | 1 | ||
| Women, n=38 | 7 (18.4) | 3 (7.9) | ||
| Men, n=10 | 1 (10) | 1 (10) | ||
| Age, years | 0.15 | 0.08 | ||
| 31–50, n=12 | 1 (8.3) | 1 (8.3) | ||
| 51–65, n=21 | 2 (9.5) | 0 | ||
| 66–81, n=15 | 5 (33.3) | 3 (20) | ||
| Smoking history | 0.9 | 0.24 | ||
| Never, n=14 | 3 (21.4) | 2 (14.3) | ||
| Former‡, n=16 | 2 (12.5) | 2 (12.5) | ||
| Active, n=18 | 3 (16.7) | 0 | ||
| History of hypertension, n=26 | 6 (23.1) | 0.26 | 4 (15.4) | 0.11§ |
| Aspirin dose | 1 | 1 | ||
| 81 mg, n=6 | 1 (16.7) | 1 (16.7) | ||
| 325 mg, n=42 | 7 (16.7) | 3 (7.1) | ||
| P2Y12 receptor antagonist | 0.33 | |||
| Clopidogrel, n=35 | 5 (14.3) | 2 (5.7) | ||
| Prasugrel, n=12 | 3 (25) | 0.5 | 2 (16.7) | |
| Ticagrelor, n=1 | 0 | 0 | ||
| Pre-procedure PRU value | <0.001§ | <0.001§ | ||
| <60, n=13 | 2 (15.4) | 2 (15.4) | ||
| 60–200, n=32 | 3 (9.4) | 0 | ||
| >240, n=3 | 3 (100) | 2 (66.7) | ||
| Post-procedure corticosteroids | 0.6 | 0.52 | ||
| None, n=3 | 0 | 0 | ||
| Methylprednisolone, n=32 | 5 (15.6) | 2 (6.3) | ||
| Dexamethasone, n=13 | 3 (23.1) | 2 (15.4) | ||
| Distal access catheter | 0.7 | 0.6 | ||
| Reflex, n=25 | 5 (20) | 3 (12) | ||
| Neuron, n=23 | 3 (13) | 1 (4.3) | ||
| Microwire | 0.47 | 0.44 | ||
| Headliner, n=35 | 7 (20) | 4 (11.4) | ||
| Traxcess, n=7 | 1 (14.3) | 0 | ||
| Avigo, n=6 | 0 | 0 | ||
| Aneurysm location¶ | 0.44 | 0.7 | ||
| ICA, n=35 | 7 (20) | 4 (11.4) | ||
| ACA/MCA, n=8 | 0 | 0 | ||
| Posterior, n=5 | 1 (20) | 0 | ||
| Maximum aneurysm size¶ | 0.2 | 0.28 | ||
| <5 mm, n=15 | 1 (6.7) | 0 | ||
| ≥5 and <10, n=13 | 1 (7.7) | 1 (7.7) | ||
| ≥10, n=20 | 6 (30) | 3 (15) | ||
| Wide-neck (≥4 mm)¶, n=29 | 6 (20.7) | 0.45 | 3 (10.3) | 0.6 |
| Fusiform morphology¶, n=7 | 3 (42.9) | 0.08 | 2 (28.6) | 0.1 |
| Vessel from neck/sac, n=26 | 3 (11.5) | 0.44 | 1 (3.9) | 0.32 |
| Number of PEDs deployed | 0.07 | 0.03 | ||
| 1, n=37 | 4 (10.8) | 1 (2.7) | ||
| >1, n=11 | 4 (36.7) | 3 (27.3) | ||
| Technically difficult procedure, n=17 | 6 (35.3) | 0.02§ | 3 (17.6) | 0.12 |
*For univariate analysis with χ2 or Fisher exact test.
†Resulting in death or permanent disabling neurological deficit.
‡Ceased smoking >6 months before procedure.
§Independent predictor in multivariate regression analysis (p≤0.05).
¶For largest aneurysm treated.
ACA, anterior cerebral artery; ICA, internal carotid artery; MCA, middle cerebral artery; PRU, P2Y12 reaction units.