Factors affecting the obliteration rate of Intracranial Aneurysms treated with a single Pipeline Embolization Device

Abstract Objective To evaluate the clinical and angiographic outcomes of intracranial aneurysm treatment using a single Pipeline Embolization Device (PED), and to evaluate the factors affecting aneurysm obliteration rate. Methods The demographic characteristics and anatomical features of 58 aneurysms in 47 patients treated with a single Pipeline embolization device were reviewed retrospectively. All aneurysms treated with one PED at a single center, and with follow-up angiograms of at least six months were included in this study. Results The overall rate of complete and near-complete occlusion was 84% (49/58) after a mean follow-up period of 18.3 months. The complete aneurysm obliteration rate was reduced when an arterial branch arose from the aneurysm neck; 13% (1/8) compared with 68% (34/50) for aneurysms without an arterial branch (P value: 0.0075). The overall complete and near-complete aneurysm occlusion rate was 90% (45/50) in aneurysms without an arterial branch arising from its neck. There was no statistically significant association between neck-width, aneurysm size, type, or history of prior coil embolization on obliteration rate. Conclusions Our data suggests that a single PED is sufficient to induce complete or near-complete obliteration of most aneurysms. The presence of a branching artery arising from the aneurysm neck is highly predictive of incomplete occlusion after treatment with a single PED.