Pipeline embolization device for the treatment of vertebral artery aneurysms: the fate of covered branch vessels.
BACKGROUND
Preliminary studies suggest that flow-diverting stents may be suitable for the treatment of aneurysms of the posterior circulation. The safety and efficacy of using flow-diverting stents for vertebral artery (VA) aneurysms is not well defined.


OBJECTIVE
To examine the fate of covering the posterior inferior cerebellar artery (PICA) in patients undergoing placement of a flow-diverting stent for VA aneurysm.


METHODS
Consecutive patients who underwent placement of a Pipeline Embolization Device (PED) for treatment of an aneurysm of the V4 segment of the VA between April 2012 and June 2015 at our institution were retrospectively evaluated. Angiograms were reviewed to determine the patency of the PICA when the vessel origin was covered by the PED.


RESULTS
11 patients with VA aneurysms who underwent treatment with the PED were identified. In each case the device covered the origin of the PICA. Follow-up angiography in eight patients demonstrated thrombosis of the aneurysm with patency of the PICA.


CONCLUSIONS
Flow-diverting stents can be used for the treatment of VA aneurysms. When appropriately sized to the vessel wall and positioned in the VA, the device may cover the origin of the PICA without impairing flow through the branching artery.
Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah.
Marcus D
MD
Mazur
Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah.
Craig
C
Kilburg
Department of Neurology, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah.
Victor
V
Wang
Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah.
Philipp
P
Taussky
D000328:Adult; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000000981:diagnostic imaging; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D020767:Intracranial Thrombosis / Q000209:etiology; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014711:Vertebral Artery
D010975:Platelet Aggregation Inhibitors