Neurosurgery’s Editor’s Choice: Pipeline Embolization Device for Small Intracranial Aneurysms: Evaluation of Safety and Efficacy in a Multicenter Cohort

The flow-diverting Pipeline Embolization Device (PED; Covidien-Ev3, Plymouth, Minnesota) was approved by the US Food and Drug Administration in 2011 for the endovascular treatment of adults with large or giant wide-necked intracranial aneurysms of the internal carotid artery (ICA) from the petrous to the superior hypophyseal segments. This approval was based on data from the Pipeline for Uncoilable or Failed Aneurysms (PUFS) and Pipeline Embolization Device for the Intracranial Treatment of Aneurysms (PITA) trials.13Recently, the number of reports on the off-label use of PED has increased significantly, and reports include, but are not limited to, ruptured aneuyrsms,4 aneurysms of the posterior circulation.57aneurysms of the distal anterior circulation,8 dissecting and fusiform aneurysms,6,9,10 aneurysms in children,11 perforating artery aneurysms,12 and small aneu-rysms.13,14

Data on the use of PED for the treatment of small aneurysms of the ICA are limited to a single-center series, limiting the ability to make meaningful and generalizable conclusions. We present a series of small intracranial aneurysms (≤7 mm) treated with a PED at 5 major academic centers in the United States to evaluate its safety and efficacy in a multicenter cohort.

From Pipeline Embolization Device for Small Intracranial Aneurysms: Evaluation of Safety and Efficacy in a Multicenter Cohort by Christoph J. Griessenauer, MD, Christopher S. Ogilvy, MD, Paul M. Foreman, MD, Michelle H. Chua, BS, Mark R. Harrigan, MD, Lucy He, MD, Matthew R. Fusco, MD, J.D. Mocco, MD, MS, Christopher J. Stapleton, MD, Aman B. Patel, MD, Ashish Sonig, MD, Adnan H. Siddiqui, MD, Ajith J. Thomas, MD

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