Application and outcome analysis of treatment of intracranial complex aneurysm using Pipeline flow diversion device

Objective To investigate the safety and efficacy of treatment of intracranial complex aneurysms using Pipeline embolization device (PED). Methods We retrospectively analyzed the clinical data of 48 patients (56 intracranial aneurysms) who were treated with PED at 6 hospitals in Shandong province from January 2015 to October 2016. The average diameter of 56 aneurysms was 10.8±8.6 mm. There were 33 (58.9%) saccular aneurysms, 7 (12.5%) blood blister-like aneurysms, 1 (1.8%) dissecting aneurysm and 15 (26.8%) irregular shaped aneurysms. There were 55 (98.2%) aneurysms located at internal carotid artery and 1 (1.8%) located at vertebral artery. The instant efficacy of embolization was evaluated according to Kamran classification. The efficacy of embolization during the follow-up was assessed by Cekirge classification. Results Among all 56 aneurysms, Kamran grade 1 was reported in 13 (23.2%) aneurysms, grade 2 in 20 (35.7%), grade 3 in 11 (19.6%) and grade 4 in 12 (21.4%). The intraparenchymal hemorrhage rate was 6.3% (3 cases) and the mortality rate was 4.2% (2 cases) within 7 days post operation. Thirty-three cases were followed up for 3-16 months post operation. Complete occlusion (Cekirge grade 1) was achieved in 72.5% (29/40), neck filling (Cekirge grade 2) in 12.5% (5/40) and incomplete occlusion with aneurysm filling (Cekirge grade 3) in 15.0% (6/40). Conclusion The complication rate seems relatively low in patients with intracranial aneurysms treated with PED and the complete occlusion rate of aneurysms is satisfactory in early and mid-term follow-up. Key words: Intracranial aneurysm; Embolization, therapeutic; Treatment outcome; Pipeline embolization device; Flow diversion