Spontaneous Delayed Migration/Shortening of the Pipeline Embolization Device: Report of 5 Cases
Spontaneous Delayed Migration/Shortening of the Pipeline Embolization Device: Report of 5 Cases
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DOI：
10.3174/ajnr.a3632
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发表时间：
2013-12-01
影响因子：
3.5
通讯作者：
Jabbour, P. M.
中科院分区：
文献类型：
--
作者：
Chalouhi, N.;Tjoumakaris, S. I.;Jabbour, P. M.
5例患者在随诊的血管造影中发现他们的管道栓塞器有自发的延迟移动/缩短。装置向近端移位4例，向远端移位1例。一名患者出现蛛网膜下腔出血，因管道栓塞器移位而死亡，另一名患者出现大脑中动脉完全闭塞，严重致残。流入和流出血管之间的动脉直径不匹配是经常发现的。对管道栓塞器的移位进行保守管理，附加放置该装置，或闭塞母体血管。使用较长的栓塞器使栓塞器完全扩张，增加血管覆盖率，使用附着性动脉瘤弹簧圈，避免装置的拖拽和拉伸是重要的预防措施。神经干预者应该意识到这种潜在的致命并发症，并采取所有必要的预防措施。
Five patients were found to have spontaneous delayed migration/shortening of their Pipeline Embolization Devices on follow-up angiography. The device migrated proximally in 4 patients and distally in 1 patient. One patient had a subarachnoid hemorrhage and died as a result of migration of the Pipeline Embolization Device, and another patient presented with complete MCA occlusion and was left severely disabled. Mismatch in arterial diameter between inflow and outflow vessels was a constant finding. Migration of the Pipeline Embolization Device was managed conservatively, with additional placement of the device, or with parent vessel occlusion. Obtaining complete expansion of the embolization device by using a longer device, increasing vessel coverage, using adjunctive aneurysm coiling, and avoiding dragging and stretching of the device are important preventive measures. Neurointerventionalists should be aware of this potentially fatal complication and take all necessary preventive measures.