Estimating the proportion of intracranial aneurysms likely to be amenable to treatment with the pipeline embolization device

Waleed Brinjikji, Harry J. Cloft, David Fiorella, Giuseppe Lanzino, David F. Kallmes

Research output: Contribution to journalArticle

31 Scopus citations

Abstract

Objective: A study was undertaken to estimate the fraction of intracranial aneurysms that might be amenable to treatment with the pipeline embolization device (PED), a current flow diverter device, and to determine the types of aneurysms that are probably not amenable to treatment with this device. Methods: A retrospective analysis of 200 consecutive intracranial aneurysms as seen on three-dimensional rotational angiography images was conducted. Based on aneurysm and parent artery morphology, four independent observers experienced in the use of the PED judged the likelihood that a given aneurysm could theoretically be treated with one or more PED using a 5-point scale: grades 1 and 2 indicated amenability to treatment with multiple devices; grade 3 indicated amenability to treatment with one device; and grades 4 and 5 indicated the aneurysm would not be amenable to treatment with the PED. Aneurysms were analyzed on the basis of anatomical factors only. Rupture status was not considered. Interobserver agreement was determined. Results: 94 of 200 aneurysms (47%) were judged to be likely to be amenable to treatment with the PED; 50 cases (25%) were judged to be amenable to the use of multiple overlapping devices while, in 44 cases (22%), coverage with a single device was preferred. There was a significant relationship between the location of the aneurysm and the grade of the aneurysm (p<0.0001). Conclusion: On the basis of anatomical configuration, nearly half of the aneurysms in this study were likely to be amenable to treatment with the PED.

Original languageEnglish (US)
Pages (from-to)45-48
Number of pages4
JournalJournal of neurointerventional surgery
Volume5
Issue number1
DOIs
StatePublished - Jan 2013

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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