The Pipeline Embolization Device for the Intracranial Treatment of Aneurysms Trial

Nelson, Peter Kim; Lylyk, Pedro; Szikora, István; Wetzel, Stephan G.; Wanke, Isabel; Fiorella, David

doi:10.3174/ajnr.a2421

Cited by 749 publications

(594 citation statements)

References 24 publications

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“…Moreover, the rigorous blinded retrospective assessment of the clinical and radiological outcomes by authors not involved in the initial treatment guarantees a fair appraisal of the techniques discussed. eurysm [51][52][53][54][55] . A series of flow diverter devices can be placed and overlapped to aid in aneurysm thrombosis or to extend the overall construct length for particularly long aneurysms.…”

Section: Study Limitationsmentioning

confidence: 99%

Vertebro-Basilar Junction Aneurysms: A Single Centre Experience and Meta-Analysis of Endovascular Treatments

et al. 2014

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Section: Study Limitationsmentioning

confidence: 99%

Vertebro-Basilar Junction Aneurysms: A Single Centre Experience and Meta-Analysis of Endovascular Treatments

et al. 2014

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“…The safety and efficacy of the PED has been unequivocally demonstrated for these aneurysms of the cavernous and supraclinoid segments of the ICA. 2,10 Although the treatment of large and giant ICA aneurysms with mass-occupying coils is very frequently associated with negative neuroophthalmological outcomes 17 -observed with both hydrogel-coated coils 12,14 and platinum coils 5 -the absence of an intrasaccular element in PEDbased treatment theoretically permits a reduction in mass effect accompanying aneurysmal involution with the potential to facilitate resolution of compression-related CN deficits and optic neuropathy. The Pipeline for Uncoilable or Failed Aneurysms (PUFS) is a prospective, multicenter, and single-arm clinical trial of the PED for the treatment of unruptured large and giant aneurysms of the ICA.…”

mentioning

confidence: 99%

Neuroophthalmological outcomes associated with use of the Pipeline Embolization Device: analysis of the PUFS trial results

Sahlein

Fouladvand

Becske

et al. 2015

JNS

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. disclosure Dr. Becske is a consultant/proctor in the use of the Pipeline Embolization Device for Covidien. Dr. Saatci's institution received fees for participation in review activities from Chestnut Medical, and she received consultancy fees from ev3/Covidien. Dr. McDougall received consultancy fees from the Covidien Medical Advisory Board. Dr. Szikora and his institution received consulting fees or honoraria from Chestnut Medical, and he received consultancy fees from Stryker Neurovascular and ev3/ Covidien and speaker's and service fees for being on speakers' bureaus of Stryker Neurovascular and ev3/Covidien. Dr. Lanzino's institution received consulting fees or honoraria from ev3/Covidien and support for travel to meetings for the study or other purposes from ev3/Covidien for presentation to a FDA panel; his institution received an unrestricted educational grant from ev3/Covidien. Dr. Moran is a chief medical officer for Covidien, and he received fees from ev3/Covidien for lectures and for development of educational presentations. Dr. Woo's institution received funds for grants or for pending grants from Siemens and from MicroVention; he received royalties paid by Codman and Shurtleff for an acute stroke device after acquisition of Revasc and travel/accommodations/meeting expenses unrelated to this study from Siemens; and he is the President/CFO of Vascular Simulations. Dr. Berez was an employee of Chestnut Medical and ev3/Covidien and received patent royalties from Covidien; he has stock/stock options in Chestnut Medical and Covidien, and is a founder and employee of Chestnut; he received

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“…Early experience with flow diverters with large and wide-necked aneurysms was positive. 12,13 The current literature on the use of flow diversion for the treatment of fusiform aneurysms is limited to small case Endovascular treatment of fusiform cerebral aneurysms with the Pipeline Embolization Device series or subgroup analysis from large series. We set out to detail our experience at a single center using the Pipeline Embolization Device (PED; Covidien/ev3) for the treatment of fusiform aneurysms in a high-volume center.…”

mentioning

confidence: 99%

Endovascular treatment of fusiform cerebral aneurysms with the Pipeline Embolization Device

Monteith

Tsimpas²,

Dumont³

et al. 2014

JNS

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Object. Despite advances in surgical and endovascular techniques, fusiform aneurysms remain a therapeutic challenge. Introduction of flow-diverting stents has revolutionized the treatment of aneurysms with wide necks and of complex morphology. The authors report their experience with the endovascular treatment of fusiform aneurysms using the Pipeline Embolization Device.Methods. A retrospective review of 146 patients with cerebral aneurysms treated with the Pipeline Embolization Device between June 2011 and January 2013 was performed. Twenty-four patients were identified as having fusiform aneurysms. Twenty-four aneurysms in these 24 patients were treated. The mean patient age was 59 years. There were 9 men and 15 women. Angiographic and clinical data (including the modified Rankin Scale [mRS] score) were recorded at the time of treatment and at follow-up. The aneurysms were located in the internal carotid artery in 8 patients (33.3%), middle cerebral artery in 8 patients (33.3%), anterior cerebral artery in 1 patient (4%), and vertebrobasilar circulation in 7 patients (29%). The aneurysms were smaller than 10 mm in 3 patients, 10-25 mm in 16 patients, and larger than 25 mm in 5 patients. The mean largest dimension diameter was 18 mm.Results. Stent deployment was successful in all cases. The minor procedural morbidity was 4% (1 case). Morbidity and mortality related to aneurysm treatment were 4.2% and 4.2%, respectively. The mean mRS scores preoperatively and at clinical follow-up (median 6.0 months, mean 6.9 months) were 0.71 and 1.2, respectively (91.7% presented with an mRS score of 2 or better, and 79.2% had an mRS score of 2 or better at the 6.0-month follow-up). At clinical follow-up, 82.6% of patients were stable or had improved, 13.0% worsened, and 4.2% had died. Twentytwo (91.7%) of 24 patients had follow-up angiography available (mean follow-up time 6.3 months); 59% had excellent angiographic results (> 95% or complete occlusion), 31.8% had complete aneurysm occlusion, 27.3% had greater than 95% aneurysm occlusion, 18.2% had a moderate decrease in size (50%-95%), 4.5% had a minimal decrease in size (< 50%), 13.6% had not changed, and 4.5% had an increase in size.Conclusions. This series demonstrates that endovascular treatment of fusiform cerebral aneurysms with flow diversion was a safe and effective treatment. Procedural complications were low. Long-term morbidity and mortality rates were acceptable given the complex nature of these lesions.

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The Pipeline Embolization Device for the Intracranial Treatment of Aneurysms Trial

Cited by 749 publications

References 24 publications

Vertebro-Basilar Junction Aneurysms: A Single Centre Experience and Meta-Analysis of Endovascular Treatments

Vertebro-Basilar Junction Aneurysms: A Single Centre Experience and Meta-Analysis of Endovascular Treatments

Neuroophthalmological outcomes associated with use of the Pipeline Embolization Device: analysis of the PUFS trial results

Endovascular treatment of fusiform cerebral aneurysms with the Pipeline Embolization Device

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