Patency of anterior circulation branch vessels after Pipeline embolization: longer-term results from 82 aneurysm cases

Use of the Pipeline Embolization Device (PED) for treatment of intracranial aneurysm is increasing.  Due to the lower porosity and the flow diverting properties of the device, branch vessel patency is frequently a concern.  This retrospective study assessed the rate of intracranial internal carotid artery, anterior circulation branch vessel patency.  82 patients and 82 aneurysms were included in this study with a mean aneurysm size of 11.3 +- 6.7 mm.  127 arterial branches were covered by PED in the 82 patients, including 76 ophthalmic arteries (OphA), 28 posterior communicating arteries (PCoA), 21 anterior choroidal arteries (AChA) and 2 anterior cerebral arteries (ACA).  Of note, there was no immediate angiographic evidence of branch vessel occlusion following PED.  Mean follow up angiography was 10 months (range 3-34.7 months) and demonstrated 13 cases of branch vessel occlusion (15.8%) including the OphA, PCoA and ACA.  No instances of AchA occlusion were seen and all other cases of delayed occlusion were clinically asymptomatic.  There was a relationship between the number of PED’s deployed and the occurrence of branch vessel occlusion, however, of the PCoA and the ACA occlusions noted there was only a single PED deployed. 

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American Association of Neurological Surgeons

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