title: Long-term follow-up after treatment of intracranial aneurysms with the Pipeline embolization device: results from a single center.
abstract: OBJECTIVE
  Stent-like, self-expandable devices, the so-called flow diverters, are increasingly used for the treatment of wide-neck cerebral aneurysms. The immediate and short-term results are promising, but no long-term results are available. The purpose of our research was to report the long-term angiographic and cross-sectional imaging results after placement of a PED in 12 patients with wide-neck intracranial aneurysms.
  
  
  METHODS
  Twelve wide-neck or otherwise untreatable cerebral aneurysms in 12 patients were treated with the PED. Angiography was performed at 6 and 24 months after treatment. Additional MR and CT angiograms were acquired.
  
  
  RESULTS
  In all patients, angiographic or cross-sectional imaging follow-up of at least 27 months demonstrated complete occlusion of the aneurysms treated with the PED. There were no cases of aneurysm recurrence. Angiography at around 6 months showed complete occlusion in all cases, except 1 that showed complete occlusion at the 29-month follow-up. In 1 patient, a clinically asymptomatic 75% in-stent stenosis was seen on the angiography at 6 months but was resolved completely by balloon dilation. Device placement was successful in all patients. Distal embolization had occurred in 1 patient, but the clot was resolved completely without clinical sequelae. Almost immediate angiographic occlusion was achieved in 2 aneurysms and flow reduction in 10 aneurysms.
  
  
  CONCLUSIONS
  Treatment of wide-neck intracranial aneurysms by PED placement led to successful and durable occlusion in all cases, without severe complications. Endovascular treatment for in-stent stenosis should be considered cautiously, because the underlying stenosis may be transient and disappear within 12 months after treatment.
authors.affiliation: Department of Radiology, Medical University Graz, Graz, Austria. hannes.deutschmann@medunigraz.at
authors.forename: H A
authors.initials: HA
authors.lastname: Deutschmann
authors.forename: M
authors.initials: M
authors.lastname: Wehrschuetz
authors.forename: M
authors.initials: M
authors.lastname: Augustin
authors.forename: K
authors.initials: K
authors.lastname: Niederkorn
authors.forename: G E
authors.initials: GE
authors.lastname: Klein
mesh_terms: D000328:Adult; D000368:Aged; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome