title: Endovascular treatment of intracraneal aneurysm with pipeline embolization device: experience in four centres in Barcelona.
abstract: Flow diverters represent a useful tool in the treatment of fusiform aneurysms and wide-neck saccular aneurysms which until the advent of this technology were problematic to treat. Pipeline™ Embolization Device (PED) has been described in several series showing high rates of occlusion and being relatively safe.
  
  
  OBJECTIVE
  Shows the experience in four different neurointerventional centres in Barcelona with the PED (Covidien) between February 2010 and October 2013.
  
  
  METHODS
  We reviewed retrospectively patients treated with PED in four neurointerventional centres in Barcelona between February 2010 and October 2013.
  
  
  RESULTS
  Forty-two patients (89.4%) with non-ruptured aneurysms and five (10.6%) post-SAH were treated, with a mean age of 51 years (range 26-76). We treated 67 aneurysms with a mean of 1.4 1-3 PED per patient. We have no mortality and three post-procedural complications with clinical consequences, two of them severe with intracranial haemorrhage and the other with anterior choroidal artery thrombosis. Follow-up was in 45 patients (65 aneurysm) achieving complete occlusion in 90.8% at 12 months of follow-up. Two aneurysms which remained without any changes were distal and fusiform including main bifurcations (3.1%).
  
  
  CONCLUSIONS
  Treatment by PED of fusiform or wide-neck saccular aneurysms is associated with high rates of occlusion after six and 12 months. Correct selection of the patients, aneurysms and also specific characteristics of the Pipeline device should be known in order to select the best therapeutic option. Our findings suggest that the indication must be judged case by case in the selection of suitable patients for PED therapy.
authors.affiliation: a Hospital Universitari de Vall d'Hebron , Barcelona , Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Tomasello
authors.affiliation: a Hospital Universitari de Vall d'Hebron , Barcelona , Spain.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Romero
authors.affiliation: b Hospital Universitari de Bellvitge , Barcelona , Spain.
authors.forename: Sonia
authors.initials: S
authors.lastname: Aixut
authors.affiliation: b Hospital Universitari de Bellvitge , Barcelona , Spain.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Miquel
authors.affiliation: c Hospital Clinic , Barcelona , Spain.
authors.forename: Juan M
authors.initials: JM
authors.lastname: Macho
authors.affiliation: d Hospital Universitari Germans Trias i Pujol , Barcelona , Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Castaño
authors.affiliation: a Hospital Universitari de Vall d'Hebron , Barcelona , Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Coscojuela
authors.affiliation: b Hospital Universitari de Bellvitge , Barcelona , Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Lemus
authors.affiliation: b Hospital Universitari de Bellvitge , Barcelona , Spain.
authors.forename: Lucia
authors.initials: L
authors.lastname: Aja
authors.affiliation: c Hospital Clinic , Barcelona , Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: San Roman
authors.affiliation: c Hospital Clinic , Barcelona , Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Blasco
authors.affiliation: a Hospital Universitari de Vall d'Hebron , Barcelona , Spain.
authors.forename: Alex
authors.initials: A
authors.lastname: Rovira
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D017023:Coronary Angiography; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013030:Spain; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors
keywords: AAS: Aspirine; AHT: Arterial hypertension; Aneurysm; DM: Diabetes mellitus; EVP: Endovascular procedure; Embolization; FA: Fusiform aneurysm; FD: Flow diverter stent; Flow Diverter; ICA: Internal carotid artery; PED: Pipeline embolization device; SA: Saccular aneurysm; SAH: Subarachnoid haemorrhage; aPTT: Activated partial thromboplastin time; mRs: The modified Rankin scale