title: Treatment of blister-like aneurysms with the pipeline embolization device.
abstract: BACKGROUND
  Endovascular vessel reconstruction with the pipeline embolization device (PED) has become common practice. Data on the safety and efficacy of the PED in blister-like aneurysms (BLAs) are limited.
  
  
  OBJECTIVE
  To retrospectively present our experience with use of the PED in BLAs.
  
  
  METHODS
  A total of 8 patients harboring 8 BLAs were treated with the PED at our institution between November 2011 and April 2013.
  
  
  RESULTS
  Aneurysm size was 2.5 mm on average. Five patients had sustained a subarachnoid hemorrhage (SAH), 1 patient presented with sentinel headaches, and in 2 patients the aneurysm was incidentally discovered. Seven aneurysms arose from the ICA and 1 from the basilar artery. Placement of the PED was successful in all 8 patients. There were no procedural or perioperative complications in any of the patients. At the latest follow-up, all 8 patients achieved a favorable outcome (mRS 0-2). Angiographic follow-up was available for 6 patients at a mean time point of 3.9 months. Follow-up angiography showed 100% aneurysm occlusion in 5 patients and marked decrease in aneurysm size in 1 patient.
  
  
  CONCLUSIONS
  The findings of this study suggest that the PED may be a safe and effective treatment for BLAs. Given the limitations of other treatment modalities and the challenging nature of BLAs, flow diversion may be a valuable option for these lesions.
authors.affiliation: *Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania; ‡Department of Neurosurgery, University of Iowa, Iowa City, Iowa.
authors.forename: Nohra
authors.initials: N
authors.lastname: Chalouhi
authors.forename: Mario
authors.initials: M
authors.lastname: Zanaty
authors.forename: Stavropoula
authors.initials: S
authors.lastname: Tjoumakaris
authors.forename: L Fernando
authors.initials: LF
authors.lastname: Gonzalez
authors.forename: David
authors.initials: D
authors.lastname: Hasan
authors.forename: David
authors.initials: D
authors.lastname: Kung
authors.forename: Robert H
authors.initials: RH
authors.lastname: Rosenwasser
authors.forename: Pascal
authors.initials: P
authors.lastname: Jabbour
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000628:therapy; D017130:Angioplasty / Q000295:instrumentation / Q000379:methods; D001241:Aspirin / Q000008:administration & dosage; D001488:Basilar Artery / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000628:therapy*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002533:Cerebral Angiography / Q000379:methods; D000077144:Clopidogrel; D004359:Drug Therapy, Combination; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000628:therapy*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D011292:Premedication; D012189:Retrospective Studies; D015607:Stents; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D006493:Heparin; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin