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KMID : 1155820160110010010
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Neurointervention
2016 Volume.11 No. 1 p.10 ~ p.170
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Pipeline Embolization Device for Large/Giant or Fusiform Aneurysms: An Initial Multi-Center Experience in Korea
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Kim Byung-Moon
Shin Yong-Sam
Baik Min-Woo
Lee Deok-Hee
Jeon Pyoung
Baik Seung-Kug
Lee Tae-Hong
Kang Dong-Hoon
Suh Sang-Il
Byun Jun-Soo
Jung Jin-Young
Kwon Ki-Hun
Kim Dong-Joon
Park Keun-Young
Kim Bum-Soo
Park Jung-Cheol
Kim Seong-Rim
Kim Young-Woo
Kim Hoon
Jo Kyung-Il
Yoon Chang-Hyo
Kim Young-Soo
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Abstract
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Purpose: The purpose of this study was to assess the safety and early outcomes of the Pipeline device for large/giant or fusiform aneurysms.
Materials and 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%).
Conclusion: 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.
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KEYWORD
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Pipeline, Flow diverter, Aneurysm
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