David C Lauzier1, Brandon K Root1, Yasha Kayan2, Josser E Delgado Almandoz2, Joshua W Osbun1,3,4, Arindam R Chatterjee1,3,4, Kayla L Whaley5, Megan E Tipps5, Christopher J Moran1,4, Akash P Kansagra1,3,4. 1. Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA. 2. Division of Neurointerventional Radiology, Neuroscience Institute, Abbott Northwestern Hospital, Minneapolis, MN, USA. 3. Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA. 4. Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, USA. 5. Neuroscience Institute, Abbott Northwestern Hospital, Minneapolis, MN, USA.
Abstract
BACKGROUND AND PURPOSE: Flow diversion is commonly used to treat intracranial aneurysms in various regions of the cerebral vasculature, but is only approved for use in the internal carotid arteries. Treatment of distal PICA aneurysms with PED is sometimes performed but has not been well studied. Here, we report our experience with flow diversion of distal PICA aneurysms with PED. MATERIALS AND METHODS: Clinical and angiographic data of eligible patients was retrospectively obtained and assessed for key demographic characteristics and clinical and angiographic outcomes. Principal outcomes included rates of aneurysm occlusion, ischemic or hemorrhagic complication, technical complication, and in-stent stenosis. RESULTS: Three female and 2 male patients underwent placement of PED in the PICA for treatment of 5 distal PICA aneurysms. Clinical and angiographic follow-up was obtained for all patients. Complete aneurysm occlusion was observed in 100% (5/5) of treated aneurysms at 6 month and longest angiographic follow-up. While there were no ischemic or device-related complications, delayed hemorrhagic complications occurred in 20% (1/5) of patients. CONCLUSION: Pipeline embolization of distal PICA aneurysms can be performed in select patients. Further study is necessary in larger cohorts to better define clinical scenarios in which flow diversion in the distal PICA should be considered.
BACKGROUND AND PURPOSE: Flow diversion is commonly used to treat intracranial aneurysms in various regions of the cerebral vasculature, but is only approved for use in the internal carotid arteries. Treatment of distal PICA aneurysms with PED is sometimes performed but has not been well studied. Here, we report our experience with flow diversion of distal PICA aneurysms with PED. MATERIALS AND METHODS: Clinical and angiographic data of eligible patients was retrospectively obtained and assessed for key demographic characteristics and clinical and angiographic outcomes. Principal outcomes included rates of aneurysm occlusion, ischemic or hemorrhagic complication, technical complication, and in-stent stenosis. RESULTS: Three female and 2 male patients underwent placement of PED in the PICA for treatment of 5 distal PICA aneurysms. Clinical and angiographic follow-up was obtained for all patients. Complete aneurysm occlusion was observed in 100% (5/5) of treated aneurysms at 6 month and longest angiographic follow-up. While there were no ischemic or device-related complications, delayed hemorrhagic complications occurred in 20% (1/5) of patients. CONCLUSION: Pipeline embolization of distal PICA aneurysms can be performed in select patients. Further study is necessary in larger cohorts to better define clinical scenarios in which flow diversion in the distal PICA should be considered.
Authors: Christoph J Griessenauer; Christopher S Ogilvy; Nimer Adeeb; Adam A Dmytriw; Paul M Foreman; Hussain Shallwani; Nicola Limbucci; Salvatore Mangiafico; Ashish Kumar; Caterina Michelozzi; Timo Krings; Vitor Mendes Pereira; Charles C Matouk; Mark R Harrigan; Hakeem J Shakir; Adnan H Siddiqui; Elad I Levy; Leonardo Renieri; Thomas R Marotta; Christophe Cognard; Ajith J Thomas Journal: J Neurosurg Date: 2018-05-04 Impact factor: 5.115
Authors: Adam N Wallace; Mudassar Kamran; Thomas P Madaelil; Yasha Kayan; Joshua W Osbun; Anil K Roy; Josser E Delgado Almandoz; Christopher J Moran; Brian M Howard; Junaid Yasin; Jonathan A Grossberg Journal: World Neurosurg Date: 2018-03-14 Impact factor: 2.104
Authors: Satoshi Kiyofuji; Christopher S Graffeo; Avital Perry; Mohammad Hassan Murad; Kelly D Flemming; Giuseppe Lanzino; Leonardo Rangel-Castilla; Waleed Brinjikji Journal: J Neurointerv Surg Date: 2017-09-30 Impact factor: 5.836