title: Rescue microsurgery with bypass and stent removal following Pipeline treatment of a giant internal carotid artery terminus aneurysm.
abstract: We report the microsurgical rescue and removal of a Pipeline stent embolization of a giant internal carotid artery terminus aneurysm. After the initial placement of a Pipeline Embolization Device (PED), it migrated proximally to the cavernous carotid with the distal end free in the middle of the aneurysm, resulting in only partial aneurysm neck coverage. The patient underwent microsurgical rescue with trapping, bypass, and opening of the aneurysm with PED removal. The vessel remained patent in the proximal segment previously covered by the Pipeline stent. Microsurgical rescue for definitive aneurysm treatment with PED removal can be safe and effective for aneurysms unsuccessfully treated with PED.
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 N. Medical Drive East, Salt Lake City, Utah, 84132, USA.
authors.forename: Christian A
authors.initials: CA
authors.lastname: Bowers
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 N. Medical Drive East, Salt Lake City, Utah, 84132, USA.
authors.forename: Philip
authors.initials: P
authors.lastname: Taussky
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 N. Medical Drive East, Salt Lake City, Utah, 84132, USA.
authors.forename: Min S
authors.initials: MS
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 N. Medical Drive East, Salt Lake City, Utah, 84132, USA.
authors.forename: Jayson A
authors.initials: JA
authors.lastname: Neil
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 N. Medical Drive East, Salt Lake City, Utah, 84132, USA. neuropub@hsc.utah.edu.
authors.forename: William T
authors.initials: WT
authors.lastname: Couldwell
mesh_terms: D002343:Carotid Artery, Internal / Q000601:surgery*; D020878:Device Removal; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008866:Microsurgery / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D015607:Stents
keywords: Endovascular treatment; Giant cerebral aneurysm; Open vascular surgery; Pipeline Embolization Device; Rescue microsurgery