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    A2, M2, P2 aneurysms and beyond: results of treatment with pipeline embolization device in 65 patients

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    Authors
    Primiani, Christopher T.
    Puri, Ajit S.
    Mokin, Maxim
    UMass Chan Affiliations
    Department of Radiology
    Document Type
    Journal Article
    Publication Date
    2019-01-23
    Keywords
    aneurysm
    angiography
    artery
    blood flow
    device
    Cardiovascular Diseases
    Nervous System Diseases
    Neurology
    Radiology
    Surgery
    Surgical Procedures, Operative
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    https://doi.org/10.1136/neurintsurg-2018-014631
    Abstract
    BACKGROUND: Intracranial aneurysms located in the distal vessels are rare and remain a challenge to treat through surgical or endovascular interventions. OBJECTIVE: To describe a multicenter approach with flow diversion using the pipeline embolization device (PED) for treatment of distal intracranial aneurysms. METHODS: Cases of distal intracranial aneurysms defined as starting on or beyond the A2 anterior cerebral artery, M2 middle cerebral artery, and P2 posterior cerebral artery segments were included in the final analysis. RESULTS: 65 patients with distal aneurysms treated with the PED were analyzed. Median aneurysm size at the largest diameter was 7.0 mm, 60% were of a saccular morphology, and 9/65 (13.8%) patients presented in the setting of acute rupture. Angiographic follow-up data were available for 53 patients, with a median follow-up time of 6 months: 44/53 (83%) aneurysms showed complete obliteration, 7/53 (13.2%) showed reduced filling, and 2/53 (3%) showed persistent filling. There was no association between patient characteristics, including aneurysm size (P=0.36), parent vessel diameter (P=0.27), location (P=0.81), morphology (P=0.63), ruptured status on admission (P=0.57), or evidence of angiographic occlusion at the end of the embolization procedure (P=0.49). Clinical outcome data were available for 60/65 patients: 95% (57/60) had good clinical outcome (modified Rankin Scale score of 0-2) at 3 months. CONCLUSIONS: This large multicenter study of patients with A2, M2, and P2 distal aneurysms treated with the PED showed that flow diversion may be an effective treatment approach for this rare type of vascular pathology. The procedural compilation rate of 7.7% indicates the need for further studies as the flow diversion technology constantly evolves.
    Source

    J Neurointerv Surg. 2019 Jan 23. pii: neurintsurg-2018-014631. doi: 10.1136/neurintsurg-2018-014631. [Epub ahead of print] Link to article on publisher's site

    DOI
    10.1136/neurintsurg-2018-014631
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/48342
    PubMed ID
    30674637
    Notes

    Full author list omitted for brevity. For the full list of authors, see article.

    Related Resources

    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1136/neurintsurg-2018-014631
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