International retrospective study of the pipeline embolization device: a multicenter aneurysm treatment study
Flow diverters are increasingly used in the endovascular treatment of intracranial aneurysms. Our aim was to determine neurologic complication rates following Pipeline Embolization Device placement for intracranial aneurysm treatment in a real-world setting. We retrospectively evaluated all patients...
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| Veröffentlicht in: | American journal of neuroradiology : AJNR 2015-01, Vol.36 (1), p.108-115 |
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| creator | Kallmes, D F Hanel, R Lopes, D Boccardi, E Bonafé, A Cekirge, S Fiorella, D Jabbour, P Levy, E McDougall, C Siddiqui, A Szikora, I Woo, H Albuquerque, F Bozorgchami, H Dashti, S R Delgado Almandoz, J E Kelly, M E Turner, 4th, R Woodward, B K Brinjikji, W Lanzino, G Lylyk, P |
| description | Flow diverters are increasingly used in the endovascular treatment of intracranial aneurysms. Our aim was to determine neurologic complication rates following Pipeline Embolization Device placement for intracranial aneurysm treatment in a real-world setting.
We retrospectively evaluated all patients with intracranial aneurysms treated with the Pipeline Embolization Device between July 2008 and February 2013 in 17 centers worldwide. We defined 4 subgroups: internal carotid artery aneurysms of ≥10 mm, ICA aneurysms of |
| doi_str_mv | 10.3174/ajnr.A4111 |
| format | Article |
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We retrospectively evaluated all patients with intracranial aneurysms treated with the Pipeline Embolization Device between July 2008 and February 2013 in 17 centers worldwide. We defined 4 subgroups: internal carotid artery aneurysms of ≥10 mm, ICA aneurysms of <10 mm, other anterior circulation aneurysms, and posterior circulation aneurysms. Neurologic complications included spontaneous rupture, intracranial hemorrhage, ischemic stroke, permanent cranial neuropathy, and mortality. Comparisons were made with t tests or ANOVAs for continuous variables and the Pearson χ(2) or Fisher exact test for categoric variables.
In total, 793 patients with 906 aneurysms were included. The neurologic morbidity and mortality rate was 8.4% (67/793), highest in the posterior circulation group (16.4%, 9/55) and lowest in the ICA <10-mm group (4.8%, 14/294) (P = .01). The spontaneous rupture rate was 0.6% (5/793). The intracranial hemorrhage rate was 2.4% (19/793). Ischemic stroke rates were 4.7% (37/793), highest in patients with posterior circulation aneurysms (7.3%, 4/55) and lowest in the ICA <10-mm group (2.7%, 8/294) (P = .16). Neurologic mortality was 3.8% (30/793), highest in the posterior circulation group (10.9%, 6/55) and lowest in the anterior circulation ICA <10-mm group (1.4%, 4/294) (P < .01).
Aneurysm treatment with the Pipeline Embolization Device is associated with the lowest complication rates when used to treat small ICA aneurysms. Procedure-related morbidity and mortality are higher in the treatment of posterior circulation and giant aneurysms.</description><identifier>ISSN: 0195-6108</identifier><identifier>EISSN: 1936-959X</identifier><identifier>DOI: 10.3174/ajnr.A4111</identifier><identifier>PMID: 25355814</identifier><language>eng</language><publisher>United States: American Society of Neuroradiology</publisher><subject>Aged ; Aged, 80 and over ; Bioengineering ; Embolization, Therapeutic - adverse effects ; Embolization, Therapeutic - instrumentation ; Endovascular Procedures - adverse effects ; Endovascular Procedures - instrumentation ; Female ; Human health and pathology ; Humans ; Imaging ; Interventional ; Intracranial Aneurysm - therapy ; Life Sciences ; Male ; Middle Aged ; Neurons and Cognition ; Nuclear medicine ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Retrospective Studies</subject><ispartof>American journal of neuroradiology : AJNR, 2015-01, Vol.36 (1), p.108-115</ispartof><rights>2015 by American Journal of Neuroradiology.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><rights>2015 by American Journal of Neuroradiology 2015 American Journal of Neuroradiology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c478t-a193a78da13a36d3846a322e2723948987874caad4cfaa7635a8ea20d9a5aedc3</citedby><cites>FETCH-LOGICAL-c478t-a193a78da13a36d3846a322e2723948987874caad4cfaa7635a8ea20d9a5aedc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7965920/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7965920/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53770,53772</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25355814$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.umontpellier.fr/hal-02190598$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Kallmes, D F</creatorcontrib><creatorcontrib>Hanel, R</creatorcontrib><creatorcontrib>Lopes, D</creatorcontrib><creatorcontrib>Boccardi, E</creatorcontrib><creatorcontrib>Bonafé, A</creatorcontrib><creatorcontrib>Cekirge, S</creatorcontrib><creatorcontrib>Fiorella, D</creatorcontrib><creatorcontrib>Jabbour, P</creatorcontrib><creatorcontrib>Levy, E</creatorcontrib><creatorcontrib>McDougall, C</creatorcontrib><creatorcontrib>Siddiqui, A</creatorcontrib><creatorcontrib>Szikora, I</creatorcontrib><creatorcontrib>Woo, H</creatorcontrib><creatorcontrib>Albuquerque, F</creatorcontrib><creatorcontrib>Bozorgchami, H</creatorcontrib><creatorcontrib>Dashti, S R</creatorcontrib><creatorcontrib>Delgado Almandoz, J E</creatorcontrib><creatorcontrib>Kelly, M E</creatorcontrib><creatorcontrib>Turner, 4th, R</creatorcontrib><creatorcontrib>Woodward, B K</creatorcontrib><creatorcontrib>Brinjikji, W</creatorcontrib><creatorcontrib>Lanzino, G</creatorcontrib><creatorcontrib>Lylyk, P</creatorcontrib><title>International retrospective study of the pipeline embolization device: a multicenter aneurysm treatment study</title><title>American journal of neuroradiology : AJNR</title><addtitle>AJNR Am J Neuroradiol</addtitle><description>Flow diverters are increasingly used in the endovascular treatment of intracranial aneurysms. Our aim was to determine neurologic complication rates following Pipeline Embolization Device placement for intracranial aneurysm treatment in a real-world setting.
We retrospectively evaluated all patients with intracranial aneurysms treated with the Pipeline Embolization Device between July 2008 and February 2013 in 17 centers worldwide. We defined 4 subgroups: internal carotid artery aneurysms of ≥10 mm, ICA aneurysms of <10 mm, other anterior circulation aneurysms, and posterior circulation aneurysms. Neurologic complications included spontaneous rupture, intracranial hemorrhage, ischemic stroke, permanent cranial neuropathy, and mortality. Comparisons were made with t tests or ANOVAs for continuous variables and the Pearson χ(2) or Fisher exact test for categoric variables.
In total, 793 patients with 906 aneurysms were included. The neurologic morbidity and mortality rate was 8.4% (67/793), highest in the posterior circulation group (16.4%, 9/55) and lowest in the ICA <10-mm group (4.8%, 14/294) (P = .01). The spontaneous rupture rate was 0.6% (5/793). The intracranial hemorrhage rate was 2.4% (19/793). Ischemic stroke rates were 4.7% (37/793), highest in patients with posterior circulation aneurysms (7.3%, 4/55) and lowest in the ICA <10-mm group (2.7%, 8/294) (P = .16). Neurologic mortality was 3.8% (30/793), highest in the posterior circulation group (10.9%, 6/55) and lowest in the anterior circulation ICA <10-mm group (1.4%, 4/294) (P < .01).
Aneurysm treatment with the Pipeline Embolization Device is associated with the lowest complication rates when used to treat small ICA aneurysms. Procedure-related morbidity and mortality are higher in the treatment of posterior circulation and giant aneurysms.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Bioengineering</subject><subject>Embolization, Therapeutic - adverse effects</subject><subject>Embolization, Therapeutic - instrumentation</subject><subject>Endovascular Procedures - adverse effects</subject><subject>Endovascular Procedures - instrumentation</subject><subject>Female</subject><subject>Human health and pathology</subject><subject>Humans</subject><subject>Imaging</subject><subject>Interventional</subject><subject>Intracranial Aneurysm - therapy</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neurons and Cognition</subject><subject>Nuclear medicine</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Retrospective Studies</subject><issn>0195-6108</issn><issn>1936-959X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkV1rFDEUhoModq3e-AMklypMm89J4oWwFLWFhd4oeBdOZ866KfNlkllYf72Zbi2tVwkn73lyzvsS8pazM8mNOofbIZ6tFef8GVlxJ-vKaffzOVkx7nRVc2ZPyKuUbhlj2hnxkpwILbW2XK1IfzVkjAPkMA7Q0Yg5jmnCJoc90pTn9kDHLc07pFOYsAsDUuxvxi78uWuhLe5Dg58o0H7ucrkuOAoDzvGQepojQu5L8ch6TV5soUv45v48JT--fvl-cVltrr9dXaw3VaOMzRWUJcDYFrgEWbfSqhqkECiMkE5ZZ401qgFoVbMFMLXUYBEEax1owLaRp-TzkTvNN30plAEidH6KoYd48CME__RlCDv_a9x742rtBCuAD0fA7r-2y_XGLzUmuCtu2j0v2vf3n8Xx94wp-z6kBruuuDDOyfNal7GlUQv241HaFJdTxO0DmzO_ZOmXLP1dlkX87vESD9J_4cm_qKmeMg</recordid><startdate>20150101</startdate><enddate>20150101</enddate><creator>Kallmes, D F</creator><creator>Hanel, R</creator><creator>Lopes, D</creator><creator>Boccardi, E</creator><creator>Bonafé, A</creator><creator>Cekirge, S</creator><creator>Fiorella, D</creator><creator>Jabbour, P</creator><creator>Levy, E</creator><creator>McDougall, C</creator><creator>Siddiqui, A</creator><creator>Szikora, I</creator><creator>Woo, H</creator><creator>Albuquerque, F</creator><creator>Bozorgchami, H</creator><creator>Dashti, S R</creator><creator>Delgado Almandoz, J E</creator><creator>Kelly, M E</creator><creator>Turner, 4th, R</creator><creator>Woodward, B K</creator><creator>Brinjikji, W</creator><creator>Lanzino, G</creator><creator>Lylyk, P</creator><general>American Society of Neuroradiology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope><scope>5PM</scope></search><sort><creationdate>20150101</creationdate><title>International retrospective study of the pipeline embolization device: a multicenter aneurysm treatment study</title><author>Kallmes, D F ; 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Our aim was to determine neurologic complication rates following Pipeline Embolization Device placement for intracranial aneurysm treatment in a real-world setting.
We retrospectively evaluated all patients with intracranial aneurysms treated with the Pipeline Embolization Device between July 2008 and February 2013 in 17 centers worldwide. We defined 4 subgroups: internal carotid artery aneurysms of ≥10 mm, ICA aneurysms of <10 mm, other anterior circulation aneurysms, and posterior circulation aneurysms. Neurologic complications included spontaneous rupture, intracranial hemorrhage, ischemic stroke, permanent cranial neuropathy, and mortality. Comparisons were made with t tests or ANOVAs for continuous variables and the Pearson χ(2) or Fisher exact test for categoric variables.
In total, 793 patients with 906 aneurysms were included. The neurologic morbidity and mortality rate was 8.4% (67/793), highest in the posterior circulation group (16.4%, 9/55) and lowest in the ICA <10-mm group (4.8%, 14/294) (P = .01). The spontaneous rupture rate was 0.6% (5/793). The intracranial hemorrhage rate was 2.4% (19/793). Ischemic stroke rates were 4.7% (37/793), highest in patients with posterior circulation aneurysms (7.3%, 4/55) and lowest in the ICA <10-mm group (2.7%, 8/294) (P = .16). Neurologic mortality was 3.8% (30/793), highest in the posterior circulation group (10.9%, 6/55) and lowest in the anterior circulation ICA <10-mm group (1.4%, 4/294) (P < .01).
Aneurysm treatment with the Pipeline Embolization Device is associated with the lowest complication rates when used to treat small ICA aneurysms. Procedure-related morbidity and mortality are higher in the treatment of posterior circulation and giant aneurysms.</abstract><cop>United States</cop><pub>American Society of Neuroradiology</pub><pmid>25355814</pmid><doi>10.3174/ajnr.A4111</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Bioengineering Embolization, Therapeutic - adverse effects Embolization, Therapeutic - instrumentation Endovascular Procedures - adverse effects Endovascular Procedures - instrumentation Female Human health and pathology Humans Imaging Interventional Intracranial Aneurysm - therapy Life Sciences Male Middle Aged Neurons and Cognition Nuclear medicine Postoperative Complications - epidemiology Postoperative Complications - etiology Retrospective Studies |
| title | International retrospective study of the pipeline embolization device: a multicenter aneurysm treatment study |
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