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Pipeline Embolization Device in the Treatment of Recurrent Previously Stented Cerebral Aneurysms.

Publication ,  Journal Article
Daou, B; Starke, RM; Chalouhi, N; Tjoumakaris, S; Hasan, D; Khoury, J; Rosenwasser, RH; Jabbour, P
Published in: AJNR Am J Neuroradiol
May 2016

BACKGROUND AND PURPOSE: The use of the Pipeline Embolization Device in the management of recurrent previously stented cerebral aneurysms is controversial. The aim of this study was to evaluate the efficacy and safety of the Pipeline Embolization Device in the treatment of recurrent, previously stented aneurysms. MATERIALS AND METHODS: Twenty-one patients with previously stented recurrent aneurysms who later underwent Pipeline Embolization Device placement (group 1) were retrospectively identified and compared with 63 patients who had treatment with the Pipeline Embolization Device with no prior stent placement (group 2). Occlusion at the latest follow-up angiogram, recurrence and retreatment rates, clinical outcome, complications, and morbidity and mortality observed after treatment with the Pipeline Embolization Device were analyzed. RESULTS: Patient characteristics were similar between the 2 groups. The mean time from stent placement to recurrence was 25 months. Pipeline Embolization Device treatment resulted in complete aneurysm occlusion in 55.6% of patients in group 1 versus 80.4% of patients in group 2 (P = .036). The retreatment rate in group 1 was 11.1% versus 7.1% in group 2 (P = .62). The rate of good clinical outcome at the latest follow-up in group 1 was 81% versus 93.2% in group 2 (P = .1). Complications were observed in 14.3% of patients in group 1 and 9.5% of patients in group 2 (P = .684). CONCLUSIONS: The use of the Pipeline Embolization Device in the management of previously stented aneurysms is less effective than the use of this device in nonstented aneurysms. Prior stent placement can worsen the safety and efficacy profile of this device.

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Published In

AJNR Am J Neuroradiol

DOI

EISSN

1936-959X

Publication Date

May 2016

Volume

37

Issue

5

Start / End Page

849 / 855

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Stents
  • Retrospective Studies
  • Retreatment
  • Recurrence
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Intracranial Aneurysm
  • Humans
 

Citation

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Chicago
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Daou, B., Starke, R. M., Chalouhi, N., Tjoumakaris, S., Hasan, D., Khoury, J., … Jabbour, P. (2016). Pipeline Embolization Device in the Treatment of Recurrent Previously Stented Cerebral Aneurysms. AJNR Am J Neuroradiol, 37(5), 849–855. https://doi.org/10.3174/ajnr.A4613
Daou, B., R. M. Starke, N. Chalouhi, S. Tjoumakaris, D. Hasan, J. Khoury, R. H. Rosenwasser, and P. Jabbour. “Pipeline Embolization Device in the Treatment of Recurrent Previously Stented Cerebral Aneurysms.AJNR Am J Neuroradiol 37, no. 5 (May 2016): 849–55. https://doi.org/10.3174/ajnr.A4613.
Daou B, Starke RM, Chalouhi N, Tjoumakaris S, Hasan D, Khoury J, et al. Pipeline Embolization Device in the Treatment of Recurrent Previously Stented Cerebral Aneurysms. AJNR Am J Neuroradiol. 2016 May;37(5):849–55.
Daou, B., et al. “Pipeline Embolization Device in the Treatment of Recurrent Previously Stented Cerebral Aneurysms.AJNR Am J Neuroradiol, vol. 37, no. 5, May 2016, pp. 849–55. Pubmed, doi:10.3174/ajnr.A4613.
Daou B, Starke RM, Chalouhi N, Tjoumakaris S, Hasan D, Khoury J, Rosenwasser RH, Jabbour P. Pipeline Embolization Device in the Treatment of Recurrent Previously Stented Cerebral Aneurysms. AJNR Am J Neuroradiol. 2016 May;37(5):849–855.

Published In

AJNR Am J Neuroradiol

DOI

EISSN

1936-959X

Publication Date

May 2016

Volume

37

Issue

5

Start / End Page

849 / 855

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Stents
  • Retrospective Studies
  • Retreatment
  • Recurrence
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Intracranial Aneurysm
  • Humans