title: Pipeline Embolization Device for Large/Giant or Fusiform Aneurysms: An Initial Multi-Center Experience in Korea.
abstract: OBJECTIVE
  The purpose of this study was to assess the safety and early outcomes of the Pipeline device for large/giant or fusiform aneurysms.
  
  
  METHODS
  The Pipeline was implanted in a total of 45 patients (mean age, 58 years; M:F=10:35) with 47 large/giant or fusiform aneurysms. We retrospectively evaluated the characteristics of the treated aneurysms, the periprocedural events, morbidity and mortality, and the early outcomes after Pipeline implantation.
  
  
  RESULTS
  The aneurysms were located in the internal carotid artery (ICA) cavernous segment (n=25), ICA intradural segment (n=11), vertebrobasilar trunk (n=8), and middle cerebral artery (n=3). Procedure-related events occurred in 18 cases, consisting of incomplete expansion (n=8), shortening-migration (n=5), transient occlusion of a jailed branch (n=3), and in-stent thrombosis (n=2). Treatment-related morbidity occurred in two patients, but without mortality. Both patients had modified Rankin scale (mRS) scores of 2, but had an improved mRS score of 0 at 1-month follow-up. Of the 19 patients presenting with mass effect, 16 improved but three showed no changes in their presenting symptoms. All patients had excellent outcomes (mRS, 0 or 1) during the follow-up period (median, 6 months; range, 2-30 months). Vascular imaging follow-up (n=31, 65.9%; median, 3 months, range, 1-25 months) showed complete or near occlusion of the aneurysm in 24 patients (77.4%) and decreased sac size in seven patients (22.6%).
  
  
  CONCLUSIONS
  In this initial multicenter study in Korea, the Pipeline seemed to be safe and effective for large/giant or fusiform aneurysms. However, a learning period may be required to alleviate device-related events.
authors.affiliation: Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Byung Moon
authors.initials: BM
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Seoul St' Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors.forename: Yong Sam
authors.initials: YS
authors.lastname: Shin
authors.affiliation: Department of Neurosurgery, Bucheon St. Mary's Hospital, The Catholic University of Korea, Gyeonggi-do, Korea.
authors.forename: Min Woo
authors.initials: MW
authors.lastname: Baik
authors.affiliation: Department of Radiology, Asan Medical Center, University of Ulsan, Seoul, Korea.
authors.forename: Deok Hee
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Pyoung
authors.initials: P
authors.lastname: Jeon
authors.affiliation: Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University, Yangsan, Korea.
authors.forename: Seung Kug
authors.initials: SK
authors.lastname: Baik
authors.affiliation: Department of Radiology, Pusan National University Hospital, Pusan National University, Busan, Korea.
authors.forename: Tae Hong
authors.initials: TH
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Kyungpook National University Hospital, Kyungpook National University, Daegu, Korea.
authors.forename: Dong-Hoon
authors.initials: DH
authors.lastname: Kang
authors.affiliation: Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Sang-Il
authors.initials: SI
authors.lastname: Suh
authors.affiliation: Department of Radiology, Chung-Ang University Hospital, Seoul, Korea.
authors.forename: Jun Soo
authors.initials: JS
authors.lastname: Byun
authors.affiliation: Department of Neurosurgery, Dong-Eui Medical Center, Busan, Korea.
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Jung
authors.affiliation: Department of Neurosurgery, Sejong General Hospital, Gyeonggi-do, Korea.
authors.forename: Kihun
authors.initials: K
authors.lastname: Kwon
authors.affiliation: Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Dong Joon
authors.initials: DJ
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Keun Young
authors.initials: KY
authors.lastname: Park
authors.affiliation: Department of Radiology, Seoul St' Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors.forename: Bum-Soo
authors.initials: BS
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Asan Medical Center, University of Ulsan, Seoul, Korea.
authors.forename: Jung Cheol
authors.initials: JC
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, Bucheon St. Mary's Hospital, The Catholic University of Korea, Gyeonggi-do, Korea.
authors.forename: Seong Rim
authors.initials: SR
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Bucheon St. Mary's Hospital, The Catholic University of Korea, Gyeonggi-do, Korea.
authors.forename: Young Woo
authors.initials: YW
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Bucheon St. Mary's Hospital, The Catholic University of Korea, Gyeonggi-do, Korea.
authors.forename: Hoon
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Kyungil
authors.initials: K
authors.lastname: Jo
authors.affiliation: Department of Neurosurgery, Pusan National University Yangsan Hospital, Pusan National University, Yangsan, Korea.
authors.forename: Chang Hyo
authors.initials: CH
authors.lastname: Yoon
authors.affiliation: Department of Neurosurgery, Pusan National University Yangsan Hospital, Pusan National University, Yangsan, Korea.
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Kim
keywords: Aneurysm; Flow diverter; Pipeline