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Pipeline Embolization of Vertebrobasilar Aneurysms-A Multicenter Case Series.

Abstract：

BACKGROUND:The Pipeline Embolization Device (PED) has been increasingly used for the treatment of posterior circulation aneurysms. The purpose of the present study was to examine the clinical and angiographic outcomes of patients with vertebrobasilar aneurysms treated with the PED. METHODS:We performed a retrospective review of vertebrobasilar aneurysms treated with the PED at 4 high-volume neurovascular centers. Patient, aneurysm, and procedural data were collected, including perioperative and delayed complications. Aneurysm occlusion on follow-up imaging studies was defined as complete (100%), near-complete (>90%), or incomplete (<90%) occlusion. RESULTS:The cohort included 35 patients with 37 vertebrobasilar aneurysms who underwent 36 treatment sessions. Of the 35 patients, 10 were men (29%), and the mean patient age was 54.1 years (range, 32-75). Eight patients (23%) underwent urgent treatment because of a ruptured aneurysm (n = 6), brainstem perforator stroke (n = 1), or post-traumatic pseudoaneurysm (n = 1). Of the 37 aneurysms, 22 arose from the vertebral artery (59%) and 15 from the basilar artery (41%). Also, 19 were saccular aneurysms (51%), with a mean size of 7.7 mm (range, 1.7-38.0); 17 were fusiform aneurysms (46%), with a mean size of 11.0 mm (range, 4.3-34); and 1 was a 2.9-mm blister aneurysm. The overall procedural complication rate was 14% (5 of 36), including 3 neurologically symptomatic complications. At a mean follow-up period of 14 months (range, 3-59), 24 of 34 aneurysms (71%) were completely occluded and 29 of 34 (85%) were completely or near-completely occluded. CONCLUSION:Our results show that Pipeline embolization of vertebrobasilar aneurysms is associated with acceptable occlusion and complication rates.

journal_name

World Neurosurg

journal_title

World neurosurgery

authors

Wallace AN,Madaelil TP,Kamran M,Miller TR,Delgado Almandoz JE,Grossberg JA,Kansagra AP,Gandhi D,Kayan Y,Cawley CM,Moran CJ,Jindal G,CreveCoeur T,Howard BM,Cross DT,Kole MJ,Roy AK,Dion JE,Osbun JW

doi

10.1016/j.wneu.2018.12.116

subject

Has Abstract

pub_date

2019-01-03 00:00:00

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(18)32939-5

pub_type

杂志文章

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