title: Pipeline flow-diverter stent for endovascular treatment of intracranial aneurysms: preliminary experience in 20 patients with 27 aneurysms.
abstract: OBJECTIVE
  To report our preliminary experience with the Pipeline flow-diverter stent for the endovascular treatment (EVT) of intracranial aneurysms.
  
  
  METHODS
  Between September 2009 and October 2010, 20 patients with 27 fusiform or wide-necked unruptured aneurysms were included and treated by Pipeline stent placement alone. Technical issues, immediate findings, delayed complications, and clinical and imaging follow-up at three and six months were assessed.
  
  
  RESULTS
  EVT was successfully performed in all patients. Clinical outcome was excellent in all but one patient who died. This latter patient developed a massive infarct due to a delayed stent thrombosis. Other complications without permanent deficit included one perimesencephalic subarachnoid hemorrhage and one retroperitoneal hematoma. Minor technical issues without clinical consequence were encountered in nine patients and included stent migration, stent misplacement, unanticipated stent shortening, and the impossibility to recapture the distal coil tip of the supporting device. Angiographic follow-up in 19 patients with 25 aneurysms showed 21 complete occlusions, one neck remnant, and three incomplete occlusions. No significant parent artery stenosis was seen.
  
  
  CONCLUSIONS
  This study shows that the Pipeline stent is useful for EVT of fusiform and wide-necked intracranial aneurysms. Moreover, the stent is well tolerated with a low rate of intra-stent stenosis at short-term follow-up. However, technical improvements are needed to ensure safe and precise use of the device.
authors.affiliation: Department of Neuroradiology, Erasme University Hospital, Brussels, Belgium. blubicz@ulb.ac.be
authors.forename: Boris
authors.initials: B
authors.lastname: Lubicz
authors.forename: Laurent
authors.initials: L
authors.lastname: Collignon
authors.forename: Gaï
authors.initials: G
authors.lastname: Raphaeli
authors.forename: Olivier
authors.initials: O
authors.lastname: De Witte
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures; D017809:Fatal Outcome; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000473:pathology / Q000601:surgery; D002532:Intracranial Aneurysm / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000473:pathology / Q000601:surgery; D015607:Stents; D016896:Treatment Outcome