Reconsiderations on the use of pipeline embolization device in the treatment of intracerebral aneurysms with special angioarchitecture: fetal PCA, AVM, V-B junction and DAVF

Reconsiderations on the use of pipeline embolization device in the treatment of intracerebral aneurysms with special angioarchitecture: fetal PCA, AVM, V-B junction and DAVF
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DOI:
10.1186/s41016-018-0133-8
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发表时间:
2018
影响因子:
--
通讯作者:
Chuhan Jiang
Chuhan Jiang
中科院分区:
--
文献类型:
--
作者:
Yupeng Zhang;Peng Yan;Yuntao Di;Fei liang;Yuxiang Zhang;Shikai Liang;Chuhan Jiang

文献摘要

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Background: Pipeline embolization device (PED) has proved its safety and efficacy in the treatment of intracranial.large and giant side-wall aneurysms. With the accumulation of treatment experience, it is an inevitable trend to.expand its off-label use on aneurysms. Whether flow diversion is safe and efficient in cases with special.angioarchitecture has rarely been explored..Methods: We performed a retrospective analysis of 210 consecutive patients treated by PED for intracerebral.aneurysms in our center. Except for aneurysm, those patients also presented with special angioarchitecture:.Fetal PCA, AVM, V-B junction and DAVF..Results: Nine patients were qualified for the study. 1 was with fetal PCA, the aneurysm remained patent on.4-month follow-up. 2 with ipsilateral AVMs, one patient died due to brain hemorrhage 20 days after the.operation, the other one was only partially embolised on 6 month follow up. 3 aneurysms located at V-B.junction, angiographic follow up on 3 months demonstrated no complete occlusion of both the aneurysms,.the other patients were still on follow up. All of the 3 cases with concomitant DAVF are completely occluded.during short to midterm follow up..Conclusions: PED for aneurysms incorporated the fetal PCA and V-B junction might meet a high propensity.for incomplete occlusion during short term follow up. Aneurysm with ipsilateral AVM is not suitable for PED.treatment due to the risk of hemorrhage and incomplete occlusion during midterm follow up. For aneurysm.with concurrent DAVF, PED treatment is safe and efficient relatively in one session or by staged operation.