title: Pipeline Embolization Device with or without Adjunctive Coil Embolization: Analysis of Complications from the IntrePED Registry.
abstract: Flow diversion to treat cerebral aneurysms has revolutionized neurointerventional surgery. Because the addition of coils potentially increases the time and complexity of endovascular procedures, we sought to determine whether adjunctive coil use is associated with an increase in complications. Patients in the International Retrospective Study of Pipeline Embolization Device registry were divided into those treated with the Pipeline Embolization Device alone (n = 689 patients; n = 797 aneurysms; mean aneurysm size, 10.3 ± 7.6 mm) versus those treated with the Pipeline Embolization Device and concurrent coil embolization (n = 104 patients; n = 109 aneurysms; mean aneurysm size, 13.6 ± 7.8 mm). Patient demographics and aneurysm characteristics were examined. Rates of neurologic morbidity and mortality were compared between groups. The Pipeline Embolization Device with versus without coiling required a significantly longer procedure time (135.8 ± 63.9 versus 96.7 ± 46.2 min; P < .0001) and resulted in higher neurological morbidity (12.5% versus 7.8%; P = .13). These data suggest that either strategy represents an acceptable risk profile in the treatment of complex cerebral aneurysms and warrants further investigation.
authors.affiliation: From the Department of Neurosurgery (M.S.P., C.K., P.T.), University of Utah Health Care, Salt Lake City, Utah.
authors.forename: M S
authors.identifier: 0000-0003-1966-8863
authors.initials: MS
authors.lastname: Park
authors.affiliation: From the Department of Neurosurgery (M.S.P., C.K., P.T.), University of Utah Health Care, Salt Lake City, Utah.
authors.forename: C
authors.identifier: 0000-0001-7653-5376
authors.initials: C
authors.lastname: Kilburg
authors.affiliation: From the Department of Neurosurgery (M.S.P., C.K., P.T.), University of Utah Health Care, Salt Lake City, Utah.
authors.forename: P
authors.identifier: 0000-0001-9247-0146
authors.initials: P
authors.lastname: Taussky
authors.affiliation: Department of Neurosurgery (F.C.A., C.G.M.), Barrow Neurological Institute, Phoenix, Arizona.
authors.forename: F C
authors.identifier: 0000-0003-2655-3810
authors.initials: FC
authors.lastname: Albuquerque
authors.affiliation: Department of Radiology (D.F.K.), Mayo Clinic, Rochester, Minnesota.
authors.forename: D F
authors.identifier: 0000-0002-8495-0040
authors.initials: DF
authors.lastname: Kallmes
authors.affiliation: Department of Neurosurgery (E.I.L.), University of Buffalo, Buffalo, New York.
authors.forename: E I
authors.identifier: 0000-0002-6208-3724
authors.initials: EI
authors.lastname: Levy
authors.affiliation: Department of Neurosurgery (P.J.), Thomas Jefferson University, Philadelphia, Pennsylvania.
authors.forename: P
authors.identifier: 0000-0002-8965-2413
authors.initials: P
authors.lastname: Jabbour
authors.affiliation: Department of Neurointerventions (I.S.), National Institute of Neurosciences, Budapest, Hungary.
authors.forename: I
authors.identifier: 0000-0003-3730-3278
authors.initials: I
authors.lastname: Szikora
authors.affiliation: Department of Neuroradiology (E.B.), Ospedale Niguarda Ca' Granda, Milan, Italy.
authors.forename: E
authors.identifier: 0000-0002-5792-7187
authors.initials: E
authors.lastname: Boccardi
authors.affiliation: Department of Neurosurgery (R.A.H.), Baptist Health, Jacksonville, Florida.
authors.forename: R A
authors.identifier: 0000-0001-7195-5806
authors.initials: RA
authors.lastname: Hanel
authors.affiliation: Department of Neuroradiology (A.B.), Hôpital Gui de Chauliac, Montpellier, France.
authors.forename: A
authors.identifier: 0000-0002-9187-1375
authors.initials: A
authors.lastname: Bonafé
authors.affiliation: Department of Neurosurgery (F.C.A., C.G.M.), Barrow Neurological Institute, Phoenix, Arizona Neuropub@dignityhealth.org.
authors.forename: C G
authors.identifier: 0000-0001-7372-7049
authors.initials: CG
authors.lastname: McDougall
mesh_terms: D001807:Blood Vessel Prosthesis; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D057510:Endovascular Procedures / Q000295:instrumentation*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D016896:Treatment Outcome