Pipeline Embolization Device for Small and Medium Vertebral Artery Aneurysms: A Multicenter Study

Author:

Zhang Hongyun12,Zhang Hongqi34,Liu Jianmin5,Song Donglei6,Zhao Yuanli7,Guan Sheng8,Maimaitili Aisha9,Wang Yunyan10,Feng Wenfeng11,Wang Yang12,Wan Jieqing13,Mao Guohua14,Shi Huaizhang15,Luo Bin16,Shao Qiuji12,Chang Kaitao12,Zhang Qianqian12,He Yingkun12,Zhang Peng34,Yang Xinjian16,Li Li12,Li Tian xiao12

Affiliation:

1. Cerebrovascular Department of Interventional Center, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan province, China;

2. Neurosurgery Department of Stroke Center, Henan Provincial People's, Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, Henan, China;

3. Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, International Neuroscience Institute (China-INI), Beijing, China;

4. Department of Interventional Neuroradiology, Xuanwu Hospital, Capital Medical University, Beijing, China;

5. Changhai Hospital Affiliated to Naval Medical University, Shanghai, China;

6. Shanghai Donglei Brain Hospital, Shanghai, China;

7. Peking University International Hospital, Beijing, China;

8. First Affiliated Hospital of Zhengzhou University, Zhengzhou, China;

9. First Affiliated Hospital of Xinjiang Medical University, Urumqi, China;

10. Qilu Hospital of Shandong University, Jinan, China;

11. Nanfang Hospital, Southern Medical University, Guangzhou, China;

12. First Affiliated Hospital of Nanchang University, Nanchang, China;

13. Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China;

14. Second Affiliated Hospital of Nanchang University, Nanchang, China;

15. First Affiliated Hospital of Harbin Medical University, Harbin, China;

16. Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;

Abstract

BACKGROUND: Pipeline embolization devices (PEDs) have been increasingly used for the treatment of posterior circulation aneurysms. OBJECTIVE: To investigate the safety and efficacy of PED in the treatment of small to medium unruptured vertebral artery intracranial aneurysms (VAIAs). METHODS: Data from 76 patients with 78 unruptured small and medium (≤12 mm) VAIAs were analyzed. Data for this study come from the PLUS study, which was conducted at 14 centers in China from 2014 to 2019. Univariate analyses were performed to evaluate predictors of the occlusion and complication. RESULTS: Seventy-eight aneurysms in 76 patients were treated with PED. The mean aneurysm size was 8.28 ± 2.13 mm, and all PEDs were successfully placed. The median follow-up was 7 months and available for 67 (85.9%) aneurysms. Complete occlusion was seen in 60 (89.6%) aneurysms, which 86.6% met the primary efficacy outcome. All patients received clinical follow-up, the combined major morbidity and mortality was 2.6%, and 98.7% of patients had a good prognosis. Ischemic stroke occurred in 10.5% of patients, and adjuvant coil and successful after adjustment were predictors of ischemic stroke in the early postoperative and follow-up, respectively. There was no significant difference in the occlusion rate of aneurysm involving posterior inferior cerebellar artery (P = .78). In cases where posterior inferior cerebellar artery was covered by PED, there was no significant difference in ischemic stroke. CONCLUSION: In the treatment of unruptured ≤12 mm VAIAs, PED has a high surgical success rate, a high degree of occlusion, and low morbidity and mortality. PED may be a promising endovascular technique.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Neurology (clinical),Surgery

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