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Chiu AHY, Cheung AK, Wenderoth JD, De Villiers L, Rice H, Phatouros CC, Singh TP, Phillips TJ, McAuliffe W. Long-Term Follow-Up Results following Elective Treatment of Unruptured Intracranial Aneurysms with the Pipeline Embolization Device. AJNR Am J Neuroradiol 2015; 36:1728-34. [PMID: 25999412 DOI: 10.3174/ajnr.a4329] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 02/02/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Numerous reports of treatment of wide-neck aneurysms by flow diverters have been published; however, long-term outcomes remain uncertain. This article reports the imaging results of unruptured aneurysms treated electively with the Pipeline Embolization Device for up to 56 months and clinical results for up to 61 months. MATERIALS AND METHODS One hundred nineteen aneurysms in 98 patients from 3 centers admitted between August 2009 and June 2011 were followed at 6-month, 1-year, and 2+-year postprocedural timeframes. Analyses on the effects of incorporated vessels, previous stent placement, aneurysm size, and morphology on aneurysm occlusion were performed. RESULTS The 1- and 2+-year imaging follow-ups were performed, on average, 13 and 28 months postprocedure. At 2+-year follow-up, clinical data were 100% complete and imaging data were complete for 103/116 aneurysms (88.8%) with a 93.2% occlusion rate. From 0 to 6 months, TIA, minor stroke, and major stroke rates were 4.2%, 3.4%, and 0.8% respectively. After 6 months, 1 patient had a TIA of uncertain cause, with an overall Pipeline Embolization Device-related mortality rate of 0.8%. An incorporated vessel was significant for a delay in occlusion (P = .009) and nonocclusion at 6 months and 1 year, with a delayed mean time of occlusion from 9.1 months (95% CI, 7.1-11.1 months) to 16.7 months (95% CI, 11.4-22.0 months). Other factors were nonsignificant. CONCLUSIONS The Pipeline Embolization Device demonstrates continued very high closure rates at 2+ years, with few delayed clinical adverse sequelae. The presence of an incorporated vessel in the wall of the aneurysm causes a delay in occlusion that approaches sidewall closure rates by 2 years.
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Affiliation(s)
- A H Y Chiu
- From the Neurological Intervention and Imaging Service (Western Australia) (A.H.Y.C., A.K.C., C.C.P., T.P.S., T.J.P., W.M.), Perth, Australia
| | - A K Cheung
- From the Neurological Intervention and Imaging Service (Western Australia) (A.H.Y.C., A.K.C., C.C.P., T.P.S., T.J.P., W.M.), Perth, Australia Prince of Wales and Liverpool Hospitals (A.K.C., J.D.W.), Sydney, Australia
| | - J D Wenderoth
- Prince of Wales and Liverpool Hospitals (A.K.C., J.D.W.), Sydney, Australia
| | - L De Villiers
- Gold Coast University Hospital (L.D.V., H.R.), Gold Coast, Australia
| | - H Rice
- Gold Coast University Hospital (L.D.V., H.R.), Gold Coast, Australia
| | - C C Phatouros
- From the Neurological Intervention and Imaging Service (Western Australia) (A.H.Y.C., A.K.C., C.C.P., T.P.S., T.J.P., W.M.), Perth, Australia
| | - T P Singh
- From the Neurological Intervention and Imaging Service (Western Australia) (A.H.Y.C., A.K.C., C.C.P., T.P.S., T.J.P., W.M.), Perth, Australia
| | - T J Phillips
- From the Neurological Intervention and Imaging Service (Western Australia) (A.H.Y.C., A.K.C., C.C.P., T.P.S., T.J.P., W.M.), Perth, Australia
| | - W McAuliffe
- From the Neurological Intervention and Imaging Service (Western Australia) (A.H.Y.C., A.K.C., C.C.P., T.P.S., T.J.P., W.M.), Perth, Australia
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Chiu AHY, Chan J, Kho LK, Phatouros CC. Unusual Magnetic Resonance Imaging and Catheter Angiographic Signs of Intravascular Lymphoma. Clin Neuroradiol 2014; 25:427-9. [PMID: 25516147 DOI: 10.1007/s00062-014-0365-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 11/20/2014] [Indexed: 11/30/2022]
Affiliation(s)
- A H Y Chiu
- Neurological Intervention and Imaging Service of WA (NIISwa), Sir Charles Gairdner Hospital, First Floor, G Block, Hospital Ave, Nedlands, WA, 6009, Australia.
| | - J Chan
- Department of Neurology, Royal Perth Hospital, GPO Box X2213, 6001, Perth, WA, Australia
| | - L K Kho
- Department of Neurology, Royal Perth Hospital, GPO Box X2213, 6001, Perth, WA, Australia
| | - C C Phatouros
- Neurological Intervention and Imaging Service of WA (NIISwa), Sir Charles Gairdner Hospital, First Floor, G Block, Hospital Ave, Nedlands, WA, 6009, Australia
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