Patients with VA aneurysm who underwent PED placement with stent covering branch vessel
Patient | Presentation | Aneurysm size, morphology | Aneurysm location relative to PICA ostia | Right or left VA | VA dominance | Location of distal end of PED relative to VBJ | Covered branches | PED size (mm) | Pre-procedure P2Y12 (PRU) | Last angiography | Outcome |
---|---|---|---|---|---|---|---|---|---|---|---|
1 | Headache, facial pain | 7 mm, saccular | Distal | Right | Codominant | Proximal | PICA | 4×12 | 76 | 1 year | Aneurysm occluded, covered PICA patent, no in-stent stenosis or endoleak |
2 | Headache, facial pain | 7 mm, saccular | Involved PICA ostia | Right | Right | Proximal | PICA | 4.5×12 | 38 | 6 months | Aneurysm occluded, covered PICA patent, no in-stent stenosis or endoleak |
3 | Jaw pain and numbness, concomitant dental abscess | 4 mm, fusiform, dissecting | Proximal | Right | Left | Proximal | PICA | 5×14 | 6 | 1 year | Aneurysm occluded, covered PICA patent, no in-stent stenosis or endoleak |
4 | Headache, retro-orbital eye pain | 7 mm, fusiform dissecting | Involved PICA ostia | Right | Right | Proximal | PICA | 5×18 | 110 | 6 months | Aneurysm occluded, covered PICA patent, no in-stent stenosis or endoleak |
5 | Incidental; concomitant left carotid artery dissection | 7 mm, fusiform dissecting | Proximal | Right | Codominant | Proximal | PICA | 3.75×20 | 79 | 6 months | Aneurysm occluded, covered PICA patent, no in-stent stenosis or endoleak |
6 | Headache and neck pain after blunt head trauma | 10 mm and 5 mm, fusiform, dissecting | Distal | Right | Codominant | Proximal | PICA, ASA | 4.25×25 | 130 | 6 months | Aneurysm occluded, covered PICA and ASA patent, no in-stent stenosis or endoleak |
7 | Hunt and Hess grade 4, subarachnoid hemorrhage | 5 mm, fusiform, dissecting | Proximal | Right | Codominant | Proximal | PICA | 3.75×20 | Not obtained, abciximab given | 3 weeks | Aneurysm occluded, covered PICA patent, no in-stent stenosis or endoleak |
8 | Hunt and Hess grade 4, subarachnoid hemorrhage | 17 mm, fusiform, dissecting | Involved PICA ostia | Right | Right | Distal | PICA, contralateral VA | 3.25×20, 3.25×20 (2 total) | Not obtained, abciximab given | 6 months | Procedure complicated by in-stent thrombosis and PICA occlusion, treated with abciximab with recanalization. Aneurysm occluded after 5 months, covered PICA patent, no in-stent stenosis or endoleak; contralateral VA occluded distal to PICA |
9 | Neck pain, nausea | 5 mm, fusiform, dissecting | Distal | Left | Codominant | Proximal | PICA | 3.5×18 | 40 | Awaiting follow-up | Covered PICA patent |
10 | Headache, nausea | 18 mm, fusiform, dissecting | Distal | Right | Codominant | Proximal | PICA | 4.5×35 | 132 | Awaiting follow-up | Covered PICA patent |
11 | PICA stroke, ataxia, dysphagia, vertigo | 10 mm, fusiform, dissecting | Involved PICA ostia | Right | Codominant | Proximal | PICA | 4.25×20 | 87 | Awaiting follow-up | Covered PICA patent |
ASA, anterior spinal artery; PED, Pipeline embolization device; PICA, posterior inferior communicating artery; PRU, P2Y12 reaction unit; VA, vertebral artery; VBJ, vertebrobasilar junction.