RT Journal Article
SR Electronic
T1 Multicenter Experience with the Pipeline Flex and Vantage with Shield Technology for Intracranial Aneurysm Treatment
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1488
OP 1494
DO 10.3174/ajnr.A8352
VO 45
IS 10
A1 Goertz, Lukas
A1 Hohenstatt, Sophia
A1 Vollherbst, Dominik F.
A1 Pflaeging, Muriel
A1 Gronemann, Christian
A1 Siebert, Eberhard
A1 Zopfs, David
A1 Pennig, Lenhard
A1 Kottlors, Jonathan
A1 Schlamann, Marc
A1 Bohner, Georg
A1 Dorn, Franziska
A1 Liebig, Thomas
A1 Möhlenbruch, Markus
A1 Kabbasch, Christoph
YR 2024
UL http://www.ajnr.org/content/45/10/1488.abstract
AB BACKGROUND AND PURPOSE: The Pipeline Embolization Device is a safe and effective treatment option for intracranial aneurysms. The newer Pipeline generations have received structural refinements and a surface modification to improve deliverability, procedural safety, and angiographic outcomes. This multicenter study evaluated the clinical safety and efficacy of the 2 surface-modified Pipeline iterations, Pipeline Vantage and Pipeline Flex with Shield Technology (PFS).MATERIALS AND METHODS: Consecutive patients treated between 2017 and 2023 were retrospectively reviewed for aneurysm characteristics, procedural details, complications, and angiographic outcomes. The safety end point was the rate of procedural and postprocedural major neurologic events occurring during the hospital stay. The efficacy end point was the rate of complete occlusion at last follow-up.RESULTS: One hundred forty-one patients underwent 112 Pipeline Vantage procedures and 32 PFS procedures for 147 aneurysms with a mean size of 8.0 (SD, 5.9) mm (11% ruptured, 16% posterior circulation, 18% nonsaccular morphology). All procedures were technically successful with a mean of 1.2 devices implanted. Balloon angioplasty was required in 20/144 (13.9%) procedures. Major neurologic adverse events occurred in 6/144 (4.2%) procedures (all ischemic stroke), resulting in death in 2 (1.4%) patients. There were no hemorrhagic complications. At a mean of 11 months, complete occlusion was achieved in 85/112 (75.9%) aneurysms, 15/112 (13.4%) had an entry remnant, and 12/112 (10.7%) had an aneurysm remnant.CONCLUSIONS: The results demonstrate high feasibility, procedural safety, and efficacy of the surface-modified Pipeline flow diverters.ASAacetylsalicylic acidBAbasilar arteryDAPTdual antiplatelet therapyFDflow diverterFUfollow-upOKMO’Kelly-Marotta scaleORodds ratioPFSPipeline Flex with Shield TechnologyPVPipeline VantageSAPTsingle antiplatelet therapy