Adam N Wallace1, Yasha Kayan2, Matthew J Austin3, Josser E Delgado Almandoz2, Mudassar Kamran3, DeWitte T Cross4, Christopher J Moran4, Joshua W Osbun5, Akash P Kansagra6. 1. Division of Neurointerventional Radiology, Neuroscience Institute, Abbott Northwestern Hospital, Minneapolis, MN, United States; Department of Radiology, University of Iowa, Iowa City, IA, United States. Electronic address: adam.n.wallace@gmail.com. 2. Division of Neurointerventional Radiology, Neuroscience Institute, Abbott Northwestern Hospital, Minneapolis, MN, United States. 3. Mallinckrodt Institute of Radiology, Washington University, St Louis, MO, United States. 4. Mallinckrodt Institute of Radiology, Department of Neurosurgery, Washington University, St Louis, MO, United States. 5. Department of Neurosurgery, Mallinckrodt Institute of Radiology, Department of Neurology, Washington University, St Louis, MO, United States. 6. Mallinckrodt Institute of Radiology, Departments of Neurosurgery and Neurology, Washington University, St Louis, MO, United States.
Abstract
BACKGROUND AND PURPOSE: Flow diversion may have advantages in the treatment of posterior communicating artery (PComA) aneurysms associated with a fetal origin posterior cerebral artery (PCA), which can be challenging to treat with conventional techniques. However, a PComA incorporated into the aneurysm may prevent or delay aneurysm occlusion. Also, coverage of a fetal origin PCA risks infarction of a large vascular territory. The purpose of this study was to examine the safety and effectiveness of using the Pipeline Embolization Device (PED) to treat PComA aneurysms associated with a fetal origin PCA. PATIENTS AND METHODS: Retrospective review of PComA aneurysms associated with a fetal origin PCA treated with the PED at two neurovascular centers was performed. Periprocedural complications and clinical and angiographic outcomes were reviewed. RESULTS: Seven female patients underwent a total of seven PED procedures to treat seven PcomA aneurysms associated with a fetal origin PCA. The symptomatic complication rate was 14% (1/7) per patient and 13% (1/8) per procedure. Angiographic follow up was obtained for 6 of 7 aneurysms. Follow-up DSA at 5-7 months after treatment demonstrated complete occlusion of 17% (1/6) of aneurysms. One aneurysm was retreated with a second PED and occlusion was demonstrated 36 months after the second treatment, yielding an overall complete occlusion rate of 33% (2/6). CONCLUSIONS: PED treatment was largely ineffective at treating PComA aneurysms associated with a fetal origin PCA, and should only be considered when conventional treatment options, including microsurgical clipping, are not feasible.
BACKGROUND AND PURPOSE: Flow diversion may have advantages in the treatment of posterior communicating artery (PComA) aneurysms associated with a fetal origin posterior cerebral artery (PCA), which can be challenging to treat with conventional techniques. However, a PComA incorporated into the aneurysm may prevent or delay aneurysm occlusion. Also, coverage of a fetal origin PCA risks infarction of a large vascular territory. The purpose of this study was to examine the safety and effectiveness of using the Pipeline Embolization Device (PED) to treat PComA aneurysms associated with a fetal origin PCA. PATIENTS AND METHODS: Retrospective review of PComA aneurysms associated with a fetal origin PCA treated with the PED at two neurovascular centers was performed. Periprocedural complications and clinical and angiographic outcomes were reviewed. RESULTS: Seven female patients underwent a total of seven PED procedures to treat seven PcomA aneurysms associated with a fetal origin PCA. The symptomatic complication rate was 14% (1/7) per patient and 13% (1/8) per procedure. Angiographic follow up was obtained for 6 of 7 aneurysms. Follow-up DSA at 5-7 months after treatment demonstrated complete occlusion of 17% (1/6) of aneurysms. One aneurysm was retreated with a second PED and occlusion was demonstrated 36 months after the second treatment, yielding an overall complete occlusion rate of 33% (2/6). CONCLUSIONS: PED treatment was largely ineffective at treating PComA aneurysms associated with a fetal origin PCA, and should only be considered when conventional treatment options, including microsurgical clipping, are not feasible.
Authors: Anna Luisa Kühn; Peter Kan; Nils Henninger; Visish Srinivasan; Katyucia de Macedo Rodrigues; Ajay K Wakhloo; Matthew J Gounis; Ajit S Puri Journal: J Clin Neurosci Date: 2019-05-06 Impact factor: 1.961
Authors: David C Lauzier; Brandon K Root; Yasha Kayan; Josser E Delgado Almandoz; Joshua W Osbun; Arindam R Chatterjee; Kayla L Whaley; Megan E Tipps; Christopher J Moran; Akash P Kansagra Journal: Interv Neuroradiol Date: 2021-05-05 Impact factor: 1.610
Authors: Mario Martínez-Galdámez; Miguel Schüller-Arteaga; Jorge Galván-Fernández; Vladimir Kalousek; Ezequiel Petra; Boris Pabón; Santiago Ortega-Gutiérrez; Paloma Jiménez-Arribas; Carlos Rodríguez-Arias Journal: Interv Neuroradiol Date: 2020-09-23 Impact factor: 1.610
Authors: Miguel S Litao; Jan-Karl Burkhardt; Omar Tanweer; Eytan Raz; Paul Huang; Tibor Becske; Maksim Shapiro; Howard Riina; Peter K Nelson Journal: Neurol Int Date: 2021-05-07