OBJECTIVE: This study aims to compare the efficacy, safety, and long-term outcomes of two flow diverters, i.e., pipeline embolization device and flow re-direction endoluminal device, in the treatment of distal carotid aneurysms. METHODS: A total of 138 patients with 175 aneurysms were included from February 2012 to September 2019. Ninety-nine aneurysms were treated with flow re-direction endoluminal device and 76 with pipeline embolization device. Angiographic follow-ups were at the 6th, 12th, 24th, 36th, and 60th months; the O'Kelly-Marotta grading scale was used to assess aneurysms occlusion. Outcomes of two devices were compared; possible associations regarding patient characteristics, aneurysm properties, treatment details, and adverse events were evaluated. RESULTS: The mean follow-up period was 33 months, with 10 patients lost to follow-up. Occlusion rates at the 6th and 12th months and during the last follow-up were similar for flow re-direction endoluminal device (81%, 84%, and 90%) and pipeline embolization device (82%, 85%, and 93%). Occlusion rates were also similar after stand-alone use without coiling. There was no significant difference regarding adverse event rates with a 10.9% overall complication rate, 3.6% mortality, and 0.7% permanent morbidity. All the mortality and morbidity were related to hemorrhagic complications. Device deployment failure was observed with five flow re-direction endoluminal devices and two pipeline embolization devices, whereas two severe in-stent stenoses occurred with each device. CONCLUSIONS: Both flow re-direction endoluminal device and pipeline embolization device are feasible and effective in flow diversion of distal internal carotid artery aneurysms, with similar adverse events rates and aneurysm occlusion success. Aneurysm occlusion rates increase with time, while the presence of an integrated branch significantly decreases treatment success.
OBJECTIVE: This study aims to compare the efficacy, safety, and long-term outcomes of two flow diverters, i.e., pipeline embolization device and flow re-direction endoluminal device, in the treatment of distal carotid aneurysms. METHODS: A total of 138 patients with 175 aneurysms were included from February 2012 to September 2019. Ninety-nine aneurysms were treated with flow re-direction endoluminal device and 76 with pipeline embolization device. Angiographic follow-ups were at the 6th, 12th, 24th, 36th, and 60th months; the O'Kelly-Marotta grading scale was used to assess aneurysms occlusion. Outcomes of two devices were compared; possible associations regarding patient characteristics, aneurysm properties, treatment details, and adverse events were evaluated. RESULTS: The mean follow-up period was 33 months, with 10 patients lost to follow-up. Occlusion rates at the 6th and 12th months and during the last follow-up were similar for flow re-direction endoluminal device (81%, 84%, and 90%) and pipeline embolization device (82%, 85%, and 93%). Occlusion rates were also similar after stand-alone use without coiling. There was no significant difference regarding adverse event rates with a 10.9% overall complication rate, 3.6% mortality, and 0.7% permanent morbidity. All the mortality and morbidity were related to hemorrhagic complications. Device deployment failure was observed with five flow re-direction endoluminal devices and two pipeline embolization devices, whereas two severe in-stent stenoses occurred with each device. CONCLUSIONS: Both flow re-direction endoluminal device and pipeline embolization device are feasible and effective in flow diversion of distal internal carotid artery aneurysms, with similar adverse events rates and aneurysm occlusion success. Aneurysm occlusion rates increase with time, while the presence of an integrated branch significantly decreases treatment success.
Authors: Tibor Becske; Waleed Brinjikji; Matthew B Potts; David F Kallmes; Maksim Shapiro; Christopher J Moran; Elad I Levy; Cameron G McDougall; István Szikora; Giuseppe Lanzino; Henry H Woo; Demetrius K Lopes; Adnan H Siddiqui; Felipe C Albuquerque; David J Fiorella; Isil Saatci; Saruhan H Cekirge; Aaron L Berez; Daniel J Cher; Zsolt Berentei; Miklós Marosfoi; Peter K Nelson Journal: Neurosurgery Date: 2017-01-01 Impact factor: 4.654
Authors: Tibor Becske; David F Kallmes; Isil Saatci; Cameron G McDougall; István Szikora; Giuseppe Lanzino; Christopher J Moran; Henry H Woo; Demetrius K Lopes; Aaron L Berez; Daniel J Cher; Adnan H Siddiqui; Elad I Levy; Felipe C Albuquerque; David J Fiorella; Zsolt Berentei; Miklós Marosfoi; Saruhan H Cekirge; Peter K Nelson Journal: Radiology Date: 2013-02-15 Impact factor: 11.105
Authors: Hannes Luecking; Arnd Doerfler; Philipp Goelitz; Philip Hoelter; Tobias Engelhorn; Stefan Lang Journal: Interv Neuroradiol Date: 2019-10-09 Impact factor: 1.610
Authors: Pervinder Bhogal; Oliver Ganslandt; Hansjörg Bäzner; Hans Henkes; Marta Aguilar Pérez Journal: World Neurosurg Date: 2017-04-21 Impact factor: 2.104
Authors: Seby John; Mark D Bain; Ferdinand K Hui; M Shazam Hussain; Thomas J Masaryk; Peter A Rasmussen; Gabor Toth Journal: Neurosurgery Date: 2016-06 Impact factor: 4.654
Authors: Sebastian Fischer; Zsolt Vajda; Marta Aguilar Perez; Elisabeth Schmid; Nikolai Hopf; Hansjörg Bäzner; Hans Henkes Journal: Neuroradiology Date: 2011-09-01 Impact factor: 2.804