Pipeline Flex Embolization Device (PED Flex) for the treatment of intracranial aneurysms: Periprocedural outcomes and first-year angiographic results

Pipeline Flex Embolization Device (PED Flex) for the treatment of intracranial aneurysms: Periprocedural outcomes and first-year angiographic results

Background/aim: The Pipeline Flex Embolization Device (PED Flex) is a new updated version of the PED classic that incorporates anew delivery system to allow facilitation of stent deployment, resheathing, and removal of the capture coil. This study evaluated the PEDFlex in terms of the technical aspects of the procedure and first-year follow-up results.Materials and methods: This retrospective study involved prospectively collected data from May 2015 to August 2017. The primaryendpoint was technical aspects of the procedure, and the secondary endpoint was first-year follow-up results.Results: Forty-nine patients with 59 target intracranial aneurysms were enrolled. Patients’ mean age was 52 years (range 21−71 years),and 31 (63.0%) were female. All aneurysms except for three were unruptured. The mean aneurysm diameter was 8 mm. Forty-sevenpatients with 56 aneurysms were successfully treated. Due to advancement, repositioning, and migration problems, 8 (13.1%) stentswere not deployed and discharged. The total aneurysm occlusion rate was 77.0%. The mortality rate was 4.3%.Conclusion: Our experience shows that the applicability and safety of the renewed delivery system provided by PED Flex for improvingdevice apposition and opening has been proven with one-year angiographic and clinical follow-up results.

___

  • 1. Becske T, Potts MB, Shapiro M, Kallmes DF, Brinjikji W et al. Pipeline for uncoilable or failed aneurysms: 3-year followup results. Journal of Neurosurgery 2017; 127 (1): 81-88. doi: 10.3171/2015.6.JNS15311
  • 2. Kallmes DF, Hanel R, Lopes D, Boccardi E, Bonafé A et al. International retrospective study of the pipeline embolization device: a multicenter aneurysm treatment study. American Journal of Neuroradiology 2015; 36 (1): 108-115. doi: 10.3174/ ajnr.A4111
  • 3. Lin N, Lanzino G, Lopes DK, Arthur AS, Ogilvy CS et al. Treatment of distal anterior circulation aneurysms with the Pipeline Embolization Device: A US multicenter experience. Neurosurgery 2016; 79 (1): 14-22. doi: 10.1227/ NEU.0000000000001117
  • 4. Jiang B, Paff M, Colby GP, Coon AL, Lin LM. Cerebral aneurysm treatment: modern neurovascular techniques. Stroke and Vascular Neurology 2016; 1 (3): 93-100. doi: 10.1136/svn-2016- 000027
  • 5. Martínez-Galdámez M, Gil A, Caniego JL, Gonzalez E, Bárcena E et al. Preliminary experience with the Pipeline Flex Embolization Device: technical note. Journal of NeuroInterventional Surgery 2015; 7 (10): 748-751. doi: 10.1136/neurintsurg-2014-011385
  • 6. Duckworth EA, Nickele C, Hoit D, Belayev A, Moran CJ et al. The first North American use of the Pipeline Flex flow diverter. British Medical Journal Case Reports 2015; 2015. pii: bcr2014011548. doi: 10.1136/bcr-2014-011548
  • 7. O’Kelly CJ, Krings T, Fiorella D, Marotta TR. A novel grading scale for the angiographic assessment of intracranial aneurysms treated using flow diverting stents. Interventional Neuroradiology 2010; 16 (2): 133-137. doi: 10.1177/159101991001600204
  • 8. Colby GP, Lin LM, Caplan JM, Jiang B, Huang J et al. Immediate procedural outcomes in 44 consecutive Pipeline Flex cases: the first North American single-center series. Journal of NeuroInterventional Surgery 2016; 8 (7): 702-709. doi: 10.1136/ neurintsurg-2015-011894
  • 9. Pereira VM, Kelly M, Vega P, Murias E, Yilmaz H et al. New Pipeline Flex device: initial experience and technical nuances. Journal of NeuroInterventional Surgery 2015; 7 (12): 920-925. doi: 10.1136/neurintsurg-2014-011347
  • 10. Le EJ, Miller T, Serulle Y, Shivashankar R, Jindal G et al. Use of Pipeline Flex is associated with reduced fluoroscopy time, procedure time, and technical failure compared with the first-generation Pipeline embolization device. Journal of NeuroInterventional Surgery 2017; 9 (2): 188-191. doi: 10.1136/neurintsurg-2016-012261
  • 11. Colby GP, Bender MT, Lin LM, Beaty N, Caplan JM et al. Declining complication rates with flow diversion of anterior circulation aneurysms after introduction of the Pipeline Flex: analysis of a single-institution series of 568 cases. Journal of Neurosurgery 2018; 129 (6): 1475-1481. doi: 10.3171/2017.7.JNS171289
  • 12. Martínez-Galdámez M, Lamin SM, Lagios KG, Liebig T, Ciceri EF et al. Treatment of intracranial aneurysms using the pipeline flex embolization device with shield technology: angiographic and safety outcomes at 1-year follow-up. Journal of NeuroInterventional Surgery 2019; 11: 396-399. doi: 10.1136/neurintsurg-2018-014204
  • 13. Saatci I, Yavuz K, Ozer C, Geyik S, Cekirge HS. Treatment of intracranial aneurysms using the pipeline flow-diverter embolization device: a single-center experience with long-term follow-up results. American Journal of Neuroradiology 2012; 33 (8): 1436-1446. doi: 10.3174/ajnr.A3246
  • 14. Jabbour P, Chalouhi N, Tjoumakaris S, Gonzalez LF, Dumont AS et al. The Pipeline Embolization Device: learning curve and predictors of complications and aneurysm obliteration. Neurosurgery 2013; 73 (1): 113-120; discussion 120. doi: 10.1227/01.neu.0000429844.06955.39
  • 15. Martínez-Galdámez M, Lamin SM, Lagios KG, Liebig T, Ciceri EF et al. Periprocedural outcomes and early safety with the use of the Pipeline Flex Embolization Device with Shield Technology for unruptured intracranial aneurysms: preliminary results from a prospective clinical study. Journal of NeuroInterventional Surgery 2017; 9 (8): 772-776. doi: 10.1136/neurintsurg-2016-012896
  • 16. Lin LM, Colby GP, Kim JE, Huang J, Tamargo RJ et al. Immediate and follow-up results for 44 consecutive cases of small (< 10 mm) internal carotid artery aneurysms treated with the pipeline embolization device. Surgical Neurology International 2013; 4: 114. doi: 10.4103/2152-7806.117711
  • 17. Arrese I, Sarabia R, Pintado R, Delgado-Rodriguez M. Flowdiverter devices for intracranial aneurysms: systematic review and meta-analysis. Neurosurgery 2013; 73 (2): 193-199; discussion 199-200. doi: 10.1227/01.neu.0000430297.17961
  • 18. Brinjikji W, Murad MH, Lanzino G, Cloft HJ, Kallmes DF. Endovascular treatment of intracranial aneurysms with flow diverters: a meta-analysis. Stroke 2013; 44 (2): 442-447. doi: 10.1161/STROKEAHA.112.678151
  • 19. Oishi H, Teranishi K, Yatomi K, Fujii T, Yamamoto M et al. Flow diverter therapy using a pipeline embolization device for 100 unruptured large and giant internal carotid artery aneurysms in a single center in a Japanese population. Neurologia MedicoChirurgica (Tokyo) 2018; 58 (11): 461-467. doi: 10.2176/nmc. oa.2018-0148
  • 20. Kallmes DF, Brinjikji W, Boccardi E, Ciceri E, Diaz O et al. Aneurysm study of pipeline in an observational registry (ASPIRe). Interventional Neurology 2016; 5 (1-2): 89-99. doi: 10.1159/000446503
  • 21. Chalouhi N, Polifka A, Daou B, Kung D, Barros G et al. Inpipeline stenosis: incidence, predictors, and clinical outcomes. Neurosurgery 2015; 77 (6): 875-879; discussion 879. doi: 10.1227/NEU.0000000000000908
  • 22. Martínez-Galdámez M, Pérez S, Vega A, Ruiz P, Caniego JL et al. Endovascular treatment of intracranial aneurysms using the Pipeline Flex embolization device: a case series of 30 consecutive patients. Journal of NeuroInterventional Surgery 2016; 8 (4): 396-401. doi: 10.1136/neurintsurg-2015-011669
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

Özhan PAZARCI, Halef Okan DOĞAN, Seyran KILINÇ, İsmet Yalkin ÇAMURCU

Yasemin Özel ASLIYÜCE, Derya GÖKMEN, Özlem ÜLGER

Does mammalian target of rapamycin or sestrin 1 protein signaling have a role in bone fracture healing?

Özhan PAZARCI, Yalkın ÇAMURCU, Seyran KILINÇ, Halef Okan DOĞAN

The Turkish version of the Modified Falls Efficacy Scale: reliability and validity from the viewpoint of balance

Nilüfer ÇETİŞLİ KORKMAZ, Mehmet DURAY, Hande ŞENOL, Esra DOĞRU HÜZMELİ

The validity and reliability of the Turkish version of the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD)

Semra TOPUZ, Kardem ULAŞ, Gönül DİNÇ HORASAN

A novel marker relationship between carotid intima–media thickness and disease activity score-28 in patients with rheumatoid arthritis: human endothelial cell-specific molecule-1

Adem KÜÇÜK, Ayça TUZCU, Göksel TUZCU, Ali Uğur USLU, Ahmet OMMA, Rabia Aydoğan BAYKARA

Pipeline Flex Embolization Device (PED Flex) for the treatment of intracranial aneurysms: Periprocedural outcomes and first-year angiographic results

Hasan DİNÇ, Ender UYSAL, Eser BULUT, Ömer Naci TABAKCI, Şükrü OĞUZ

Nur Yücel EKİCİ, Özgür KÜLAHCI

The effect of pregabalin on tourniquet-induced ischemia-reperfusion injury: a prospective randomized study

Ömer KARACA, Ahmet Fevzi ÖZGÜR, Sevsen KULAKSIZOĞLU, Rafi DOĞAN, Hüseyin Ulaş PINAR

Abdominal girth has a strong correlation with actual and ultrasound estimated epidural depth

Mehmet CANTÜRK, Meltem HAKKI, Nazan KOCAOĞLU