Pipeline Embolization of Vertebrobasilar Aneurysms - a Multicenter Case Series.

Pipeline Embolization of Vertebrobasilar Aneurysms - a Multicenter Case Series.

World Neurosurg. 2019 Jan 02;:

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

Abstract
BACKGROUND: and purpose: The Pipeline Embolization Device (PED) is being increasingly utilized for treatment of posterior circulation aneurysms. The purpose of this study was to examine the clinical and angiographic outcomes of patients with vertebrobasilar aneurysms treated with the PED.
METHODS: Retrospective review of vertebrobasilar aneurysms treated with the PED at four high-volume neurovascular centers was performed. Patient, aneurysm, and procedural data were collected, including perioperative and delayed complications. Aneurysm occlusion on follow-up imaging was defined as complete (Raymond 1), near-complete (Raymond 2), or incomplete (Raymond 3).
RESULTS: The cohort included 35 patients with 37 vertebrobasilar aneurysms who underwent 36 treatments. The patients were 31% (11/35) men, mean age 54.1 years (range, 32-75 years). Eight patients (23%) were treated urgently for ruptured aneurysms (n=6), brainstem perforator stroke (n=1), or post-traumatic pseudoaneurysm (n=1). Aneurysms arose from the vertebral (59%, 22/37) or basilar artery (41%, 15/37). There were 19 saccular aneurysms (51%, 19/37), mean size 7.7 mm (range, 1.7-38.0 mm); 17 fusiform aneurysms (46%, 17/37), mean size of 11.0 mm (range, 4.3-34 mm); and one 2.9-mm blister aneurysm. The overall procedural complication rate was 14% (5/36), including three neurologically-symptomatic complications. At mean follow up of 14 months (range, 3-59 months), 71% (24/34) of aneurysms were completely occluded and 85% (29/34) were completely or near-completely occluded.
CONCLUSION: Pipeline embolization of vertebrobasilar aneurysms is associated with acceptable occlusion and complication rates.

PMID: 30610980 [PubMed - as supplied by publisher]

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