title: Preliminary experience with the Pipeline Flex Embolization Device: technical note.
abstract: BACKGROUND
  Clinical experience with the Pipeline Embolization Device (PED) has been widely described in the literature since it obtained its European CE and FDA approvals in 2008 and 2011, respectively. The new generation of PED, the Pipeline Flex Embolization Device, received the CE mark of approval in March 2014. While the implant composition has not changed, its new delivery system has some differences. One of the main changes from the previous generation is a new delivery system that makes the device resheathable until deployed over 90% of its length. We present our preliminary experience using this device.
  
  
  METHODS
  Between May and June 2014, six patients with six aneurysms were treated with the Pipeline Flex device.
  
  
  RESULTS
  All devices were placed properly, without technical difficulties. We successfully resheathed and repositioned the device in two cases. Minor and major intraprocedural or periprocedural events were noted.
  
  
  CONCLUSIONS
  The Pipeline Flex device allows more precise and controlled deployment than the current PED device. Although this preliminary experience seems positive, multicenter larger series will be needed to confirm the safety and durability of this new device.
authors.affiliation: Interventional Neuroradiology/Endovascular Neurosurgery Division, Department of Radiology, Hospital Clínico Universitario, Valladolid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Martínez-Galdámez
authors.affiliation: Interventional Neuroradiology, Radiology Department, Hospital de Cruces, Bilbao, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Gil
authors.affiliation: Interventional Neuroradiology, Radiology Department, Hospital La Princesa, Madrid, Spain.
authors.forename: J L
authors.initials: JL
authors.lastname: Caniego
authors.affiliation: Interventional Neuroradiology, Radiology Department, Hospital de Cruces, Bilbao, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Gonzalez
authors.affiliation: Interventional Neuroradiology, Radiology Department, Hospital La Princesa, Madrid, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Bárcena
authors.affiliation: Interventional Neuroradiology/Endovascular Neurosurgery Division, Department of Radiology, Hospital Clínico Universitario, Valladolid, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Perez
authors.affiliation: Interventional Neuroradiology/Endovascular Neurosurgery Division, Department of Radiology, Hospital Clínico Universitario, Valladolid, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Garcia-Bermejo
authors.affiliation: Interventional Neuroradiology/Endovascular Neurosurgery Division, Department of Neurology and Anesthesia, University of Iowa, Iowa City, Iowa, USA.
authors.forename: S
authors.initials: S
authors.lastname: Ortega-Gutierrez
mesh_terms: D004621:Embolization, Therapeutic / Q000295:instrumentation*; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D019736:Prostheses and Implants / Q000592:standards*
keywords: Aneurysm; Blood Flow; Flow Diverter