title: Endoluminal Reconstruction for Nonsaccular Aneurysms of the Proximal Posterior Cerebral Artery with the Pipeline Embolization Device.
abstract: OBJECTIVE
  Treatment options for nonsaccular posterior cerebral artery aneurysms include a range of surgical and endovascular reconstructive and deconstructive methods. However, no truly satisfactory treatment option is available to date for lesions arising from the P1 and P2 segments. The purpose of the present case series is to investigate both the efficacy and safety of the Pipeline Embolization Device in treating these challenging aneurysms.
  
  
  METHODS
  We present a series of 6 consecutive patients who underwent endoluminal reconstruction with the Pipeline Embolization Device for nonsaccular P1 or P2 segment aneurysms between January 2009 and June 2013.
  
  
  RESULTS
  Aneurysm location included the P1 segment in 2 patients and the P2 segment in 4 patients. Mean aneurysm diameter was 23 mm (range, 5-44 mm). Mean length of the arterial segment involved was 10 mm (range, 6-19 mm). Clinical presentation included mass effect in 4 patients and perforator stroke and subacute aneurysmal subarachnoid hemorrhage in 1 patient each. Endovascular reconstruction was performed by using 1 Pipeline Embolization Device in 5 patients and 2 overlapping Pipeline Embolization Devices in the remaining patient. Angiographic aneurysm occlusion was immediate in 1 patient, within 6 months in 4 patients, and within 1 year in the remaining patient. Index symptoms resolved in 4 patients and stabilized in the remaining 2. No new permanent neurologic sequelae and no aneurysm recurrence were recorded during the mean follow-up period of 613 days (range, 540-725 days).
  
  
  CONCLUSIONS
  Endovascular reconstruction with the Pipeline Embolization Device for nonsaccular aneurysms arising from the P1 and P2 segments compares favorably with historical treatment options in terms of occlusion rate, margin of safety, and neurologic outcome.
authors: From the Bernard and Irene Schwartz Interventional Neuroradiology Section, Department of Radiology (D.W.Z., M.S., T.B., E.R., M.B.P., H.A.R., P.K.N.) Departments of Neurological Surgery (D.W.Z., M.B.P., H.A.R., P.K.N.).
authors: D W
authors: DW
authors: Zumofen
authors: From the Bernard and Irene Schwartz Interventional Neuroradiology Section, Department of Radiology (D.W.Z., M.S., T.B., E.R., M.B.P., H.A.R., P.K.N.) Neurology (M.S., T.B.), New York University School of Medicine, New York, New York.
authors: M
authors: M
authors: Shapiro
authors: From the Bernard and Irene Schwartz Interventional Neuroradiology Section, Department of Radiology (D.W.Z., M.S., T.B., E.R., M.B.P., H.A.R., P.K.N.) Neurology (M.S., T.B.), New York University School of Medicine, New York, New York.
authors: T
authors: T
authors: Becske
authors: From the Bernard and Irene Schwartz Interventional Neuroradiology Section, Department of Radiology (D.W.Z., M.S., T.B., E.R., M.B.P., H.A.R., P.K.N.).
authors: E
authors: E
authors: Raz
authors: From the Bernard and Irene Schwartz Interventional Neuroradiology Section, Department of Radiology (D.W.Z., M.S., T.B., E.R., M.B.P., H.A.R., P.K.N.) Departments of Neurological Surgery (D.W.Z., M.B.P., H.A.R., P.K.N.).
authors: M B
authors: MB
authors: Potts
authors: From the Bernard and Irene Schwartz Interventional Neuroradiology Section, Department of Radiology (D.W.Z., M.S., T.B., E.R., M.B.P., H.A.R., P.K.N.) Departments of Neurological Surgery (D.W.Z., M.B.P., H.A.R., P.K.N.).
authors: H A
authors: HA
authors: Riina
authors: From the Bernard and Irene Schwartz Interventional Neuroradiology Section, Department of Radiology (D.W.Z., M.S., T.B., E.R., M.B.P., H.A.R., P.K.N.) Departments of Neurological Surgery (D.W.Z., M.B.P., H.A.R., P.K.N.) peter.nelson@nyumc.org.
authors: P K
authors: PK
authors: Nelson
mesh_terms: D000328:Adult; D000368:Aged; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D057510:Endovascular Procedures / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016896:Treatment Outcome