Time Line of Occlusion for Intracranial Aneurysms Treated with the Pipeline Embolization Device

被引:3
作者
Cler, Samuel J. [1 ]
Lauzier, David C. [1 ]
Chatterjee, Arindam R. [1 ,2 ,3 ]
Osbun, Joshua W. [1 ,2 ,3 ]
Moran, Christopher J. [1 ,2 ]
Kansagra, Akash P. [1 ,2 ,3 ,4 ]
机构
[1] Washington Univ, Mallinckrodt Inst Radiol, Sch Med, St Louis, MO 63130 USA
[2] Washington Univ, Dept Neurol Surg, Sch Med, St Louis, MO USA
[3] Washington Univ, Sch Med, Dept Neurol, St Louis, MO 63110 USA
[4] Calif Ctr Neurointervent Surg, San Diego, CA USA
关键词
Aneurysm; Flow diversion; PED; Pipeline embolization device; COMPLICATIONS;
D O I
10.1016/j.wneu.2022.07.084
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND: Rates of aneurysm occlusion following treatment with flow-diverting stents have been quantified at predefined time points in clinical trials, but data characterizing the continuous temporal progression of aneurysm occlusion are lacking. This study used real-world variability in timing of angiographic follow-up to characterize the time line of aneurysm occlusion following treatment with the Pipeline embolization device (PED). METHODS: An aneurysms treated with a PED at our institution between 2011 and 2020 were screened. Nonsaccular or ruptured aneurysms were excluded. Aneurysm occlusion status and time since treatment were recorded for each follow-up angiogram. Aneurysm occlusion was characterized using Kaplan-Meier and Cox proportional hazards analysis after censoring at last follow-up or subsequent treatment. RESULTS: There were 290 aneurysms in 222 patients analyzed. The median time of observed aneurysm occlusion was 7.5 months, and overall rate of aneurysm occlusion was 77.9%. Larger aneurysms demonstrated a longer median time to occlusion and lower rate of aneurysm occlusion (P = 0.029). There were no observed differences in the time line of occlusion for aneurysms treated with a single PED or multiple PEDs (P = 0.889) or without or with adjunctive coiling (P = 0.771). CONCLUSIONS: Aneurysms treated with a PED had a median time to observed occlusion of 7.5 months. Occlusion of larger aneurysms occurred more slowly than occlusion of smaller aneurysms following flow diversion. The number of PEDs deployed or the use of adjunctive coiling did not affect the time line or likelihood of aneurysm occlusion. These findings may guide optimal timing of followup after treatment with a PED.
引用
收藏
页码:E750 / E757
页数:8
相关论文
共 21 条
[1]   Long-Term Clinical and Angiographic Outcomes Following Pipeline Embolization Device Treatment of Complex Internal Carotid Artery Aneurysms: Five-Year Results of the Pipeline for Uncoilable or Failed Aneurysms Trial [J].
Becske, Tibor ;
Brinjikji, Waleed ;
Potts, Matthew B. ;
Kallmes, David F. ;
Shapiro, Maksim ;
Moran, Christopher J. ;
Levy, Elad I. ;
McDougall, Cameron G. ;
Szikora, Istvan ;
Lanzino, Giuseppe ;
Woo, Henry H. ;
Lopes, Demetrius K. ;
Siddiqui, Adnan H. ;
Albuquerque, Felipe C. ;
Fiorella, David J. ;
Saatci, Isil ;
Cekirge, Saruhan H. ;
Berez, Aaron L. ;
Cher, Daniel J. ;
Berentei, Zsolt ;
Marosfoi, Miklos ;
Nelson, Peter K. .
NEUROSURGERY, 2017, 80 (01) :40-48
[2]   Pipeline for Uncoilable or Failed Aneurysms: Results from a Multicenter Clinical Trial [J].
Becske, Tibor ;
Kallmes, David F. ;
Saatci, Isil ;
McDougall, Cameron G. ;
Szikora, Istvn ;
Lanzino, Giuseppe ;
Moran, Christopher J. ;
Woo, Henry H. ;
Lopes, Demetrius K. ;
Berez, Aaron L. ;
Cher, Daniel J. ;
Siddiqui, Adnan H. ;
Levy, Elad I. ;
Albuquerque, Felipe C. ;
Fiorella, David J. ;
Berentei, Zsolt ;
Marosfoi, Miklos ;
Cekirge, Saruhan H. ;
Nelson, Peter K. .
RADIOLOGY, 2013, 267 (03) :858-868
[3]   Predictors of cerebral aneurysm persistence and occlusion after flow diversion: a single-institution series of 445 cases with angiographic follow-up [J].
Bender, Matthew T. ;
Colby, Geoffrey P. ;
Lin, Li-Mei ;
Jiang, Bowen ;
Westbroek, Erick M. ;
Xu, Risheng ;
Campos, Jessica K. ;
Huang, Judy ;
Tamargo, Rafael J. ;
Coon, Alexander L. .
JOURNAL OF NEUROSURGERY, 2019, 130 (01) :259-267
[4]   A Single Pipeline Embolization Device is Sufficient for Treatment of Intracranial Aneurysms [J].
Chalouhi, N. ;
Tjoumakaris, S. ;
Phillips, J. L. H. ;
Starke, R. M. ;
Hasan, D. ;
Wu, C. ;
Zanaty, M. ;
Kung, D. ;
Gonzalez, L. F. ;
Rosenwasser, R. ;
Jabbour, P. .
AMERICAN JOURNAL OF NEURORADIOLOGY, 2014, 35 (08) :1562-1566
[5]   Delayed complications after flow-diverter stenting: Reactive in-stent stenosis and creeping stents [J].
Cohen, Jose E. ;
Gomori, John Moshe ;
Moscovici, Samuel ;
Leker, Ronen R. ;
Itshayek, Eyal .
JOURNAL OF CLINICAL NEUROSCIENCE, 2014, 21 (07) :1116-1122
[6]   The Pipeline embolization device for treatment of intracranial aneurysms [J].
Eller, Jorge L. ;
Dumont, Travis M. ;
Sorkin, Grant C. ;
Mokin, Maxim ;
Levy, Elad I. ;
Snyder, Kenneth V. ;
Hopkins, L. Nelson ;
Siddiqui, Adnan H. .
EXPERT REVIEW OF MEDICAL DEVICES, 2014, 11 (02) :137-150
[7]   A survey of intracranial aneurysm treatment practices among United States physicians [J].
Fargen, Kyle M. ;
Soriano-Baron, Hector E. ;
Rushing, Julia T. ;
Mack, William ;
Mocco, J. ;
Albuquerque, Felipe ;
Ducruet, Andrew F. ;
Mokin, Maxim ;
Linfante, Italo ;
Wolfe, Stacey Q. ;
Wilson, John A. ;
Hirsch, Joshua A. .
JOURNAL OF NEUROINTERVENTIONAL SURGERY, 2018, 10 (01) :44-49
[8]   Proposal of a follow-up imaging strategy following Pipeline flow diversion treatment of intracranial aneurysms [J].
Gupta, Raghav ;
Ogilvy, Christopher S. ;
Moore, Justin M. ;
Griessenauer, Christoph J. ;
Enriquez-Marulanda, Alejandro ;
Leadon, Madeline ;
Adeeb, Nimer ;
Ascanio, Luis ;
Maragkos, Georgios A. ;
Jain, Abhi ;
Schmalz, Philip G. R. ;
Alturki, Abdulrahman Y. ;
Kicielinski, Kimberly ;
Schirmer, Clemens M. ;
Thomas, Ajith J. .
JOURNAL OF NEUROSURGERY, 2019, 131 (01) :32-39
[9]   Prospective study on embolization of intracranial aneurysms with the pipeline device: the PREMIER study 1 year results [J].
Hanel, Ricardo A. ;
Kallmes, David F. ;
Lopes, Demetrius Klee ;
Nelson, Peter Kim ;
Siddiqui, Adnan ;
Jabbour, Pascal ;
Pereira, Vitor M. ;
Istvan, Istvan Szikora ;
Zaidat, Osama O. ;
Bettegowda, Chetan ;
Colby, Geoffrey P. ;
Mokin, Maxim ;
Schirmer, Clemens ;
Hellinger, Frank R. ;
Given, Curtis, II ;
Krings, Timo ;
Taussky, Philipp ;
Toth, Gabor ;
Fraser, Justin F. ;
Chen, Michael ;
Priest, Ryan ;
Kan, Peter ;
Fiorella, David ;
Frei, Don ;
Aagaard-Kienitz, Beverly ;
Diaz, Orlando ;
Malek, Adel M. ;
Cawley, C. Michael ;
Puri, Ajit S. .
JOURNAL OF NEUROINTERVENTIONAL SURGERY, 2020, 12 (01) :62-66
[10]   Data generation for the Cox proportional hazards model with time-dependent covariates: a method for medical researchers [J].
Hendry, David J. .
STATISTICS IN MEDICINE, 2014, 33 (03) :436-454