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<meta name="DC.Title" content="Safety of the Pipeline Embolization Device in Treatment of Posterior Circulation Aneurysms" />
<meta name="DC.Identifier" content="10.3174/ajnr.A3166" />
<meta name="DC.Date" content="2012-08-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2012 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: The published results of treating internal carotid artery aneurysms with the PED do not necessarily apply to its use in the posterior circulation because disabling brain stem infarcts can be caused by occlusion of a single perforator. In this multicenter study, we assessed the safety of PED placement in the posterior circulation.

MATERIALS AND METHODS: A prospective case registry was maintained of all posterior circulation aneurysms treated with PEDs at 3 Australian neurointerventional centers during a 27-month period. The objective was to assess the complications and aneurysm occlusion rates associated with posterior circulation PEDs.

RESULTS: Thirty-two posterior circulation aneurysms were treated in 32 patients. No deaths or poor neurologic outcomes occurred. Perforator territory infarctions occurred in 3 (14%) of the 21 patients with basilar artery aneurysms, and in all 3, a single PED was used. Two asymptomatic intracranial hematomas were recorded. No aneurysm rupture or PED thrombosis was encountered. The overall rate of permanent neurologic complications was 9.4% (3/32); all 3 patients had very mild residual symptoms and a good clinical outcome. Aneurysm occlusion was demonstrated in 85% of patients with &gt;6 months of follow-up and 96% of patients with &gt;1 year of follow-up.

CONCLUSIONS: The PED is effective in the treatment of posterior circulation aneurysms that are otherwise difficult or impossible to treat with standard endovascular or surgical techniques, and its safety is similar to that of stent-assisted coiling techniques. A higher clinical perforator infarction rate may be associated with basilar artery PEDs relative to the internal carotid artery.

mRS
:   modified Rankin Scale
PED
:   Pipeline Embolization Device
SFD
:   Silk flow diverter
TGA
:   Therapeutic Goods Association
WFNS
:   World Federation of Neurological Surgeons" />
<meta name="DC.Contributor" content="T.J. Phillips" />
<meta name="DC.Contributor" content="J.D. Wenderoth" />
<meta name="DC.Contributor" content="C.C. Phatouros" />
<meta name="DC.Contributor" content="H. Rice" />
<meta name="DC.Contributor" content="T.P. Singh" />
<meta name="DC.Contributor" content="L. Devilliers" />
<meta name="DC.Contributor" content="V. Wycoco" />
<meta name="DC.Contributor" content="S. Meckel" />
<meta name="DC.Contributor" content="W. McAuliffe" />
<meta name="article:published_time" content="2012-08-01" />
<meta name="article:section" content="Expedited Publication" />
<meta name="citation_title" content="Safety of the Pipeline Embolization Device in Treatment of Posterior Circulation Aneurysms" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;The published results of treating internal carotid artery aneurysms with the PED do not necessarily apply to its use in the posterior circulation because disabling brain stem infarcts can be caused by occlusion of a single perforator. In this multicenter study, we assessed the safety of PED placement in the posterior circulation.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;A prospective case registry was maintained of all posterior circulation aneurysms treated with PEDs at 3 Australian neurointerventional centers during a 27-month period. The objective was to assess the complications and aneurysm occlusion rates associated with posterior circulation PEDs.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Thirty-two posterior circulation aneurysms were treated in 32 patients. No deaths or poor neurologic outcomes occurred. Perforator territory infarctions occurred in 3 (14%) of the 21 patients with basilar artery aneurysms, and in all 3, a single PED was used. Two asymptomatic intracranial hematomas were recorded. No aneurysm rupture or PED thrombosis was encountered. The overall rate of permanent neurologic complications was 9.4% (3/32); all 3 patients had very mild residual symptoms and a good clinical outcome. Aneurysm occlusion was demonstrated in 85% of patients with &amp;gt;6 months of follow-up and 96% of patients with &amp;gt;1 year of follow-up.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;The PED is effective in the treatment of posterior circulation aneurysms that are otherwise difficult or impossible to treat with standard endovascular or surgical techniques, and its safety is similar to that of stent-assisted coiling techniques. A higher clinical perforator infarction rate may be associated with basilar artery PEDs relative to the internal carotid artery.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_publication_date" content="2012/08/01" />
<meta name="citation_mjid" content="ajnr;33/7/1225" />
<meta name="citation_id" content="33/7/1225" />
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<meta name="citation_issn" content="0195-6108" />
<meta name="citation_issn" content="1936-959X" />
<meta name="citation_doi" content="10.3174/ajnr.A3166" />
<meta name="citation_pmid" content="22678845" />
<meta name="citation_volume" content="33" />
<meta name="citation_issue" content="7" />
<meta name="citation_article_type" content="Research Article" />
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<meta name="citation_firstpage" content="1225" />
<meta name="citation_lastpage" content="1231" />
<meta name="citation_author" content="T.J. Phillips" />
<meta name="citation_author_institution" content="aFrom the Department of Neurological Intervention and Imaging Western Australia (T.J.P., C.C.P., T.P.S., V.W., W.M.), Sir Charles Gairdner Hospital, Perth, Australia" />
<meta name="citation_author" content="J.D. Wenderoth" />
<meta name="citation_author_institution" content="cNeurointerventional Service (J.D.W.), Prince of Wales Hospital and Liverpool Hospital, Sydney, Australia" />
<meta name="citation_author" content="C.C. Phatouros" />
<meta name="citation_author_institution" content="aFrom the Department of Neurological Intervention and Imaging Western Australia (T.J.P., C.C.P., T.P.S., V.W., W.M.), Sir Charles Gairdner Hospital, Perth, Australia" />
<meta name="citation_author" content="H. Rice" />
<meta name="citation_author_institution" content="bNeurointerventional Section (H.R., L.D.), Gold Coast Hospital, Surfers Paradise, Queensland, Australia" />
<meta name="citation_author" content="T.P. Singh" />
<meta name="citation_author_institution" content="aFrom the Department of Neurological Intervention and Imaging Western Australia (T.J.P., C.C.P., T.P.S., V.W., W.M.), Sir Charles Gairdner Hospital, Perth, Australia" />
<meta name="citation_author" content="L. Devilliers" />
<meta name="citation_author_institution" content="bNeurointerventional Section (H.R., L.D.), Gold Coast Hospital, Surfers Paradise, Queensland, Australia" />
<meta name="citation_author" content="V. Wycoco" />
<meta name="citation_author_institution" content="aFrom the Department of Neurological Intervention and Imaging Western Australia (T.J.P., C.C.P., T.P.S., V.W., W.M.), Sir Charles Gairdner Hospital, Perth, Australia" />
<meta name="citation_author" content="S. Meckel" />
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<meta name="twitter:title" content="Safety of the Pipeline Embolization Device in Treatment of Posterior Circulation Aneurysms" />
<meta name="twitter:card" content="summary_large_image" />
<meta name="twitter:image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/33/7.cover-source.jpg" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: The published results of treating internal carotid artery aneurysms with the PED do not necessarily apply to its use in the posterior circulation because disabling brain stem infarcts can be caused by occlusion of a single perforator. In this multicenter study, we assessed the safety of PED placement in the posterior circulation.

MATERIALS AND METHODS: A prospective case registry was maintained of all posterior circulation aneurysms treated with PEDs at 3 Australian neurointerventional centers during a 27-month period. The objective was to assess the complications and aneurysm occlusion rates associated with posterior circulation PEDs.

RESULTS: Thirty-two posterior circulation aneurysms were treated in 32 patients. No deaths or poor neurologic outcomes occurred. Perforator territory infarctions occurred in 3 (14%) of the 21 patients with basilar artery aneurysms, and in all 3, a single PED was used. Two asymptomatic intracranial hematomas were recorded. No aneurysm rupture or PED thrombosis was encountered. The overall rate of permanent neurologic complications was 9.4% (3/32); all 3 patients had very mild residual symptoms and a good clinical outcome. Aneurysm occlusion was demonstrated in 85% of patients with &gt;6 months of follow-up and 96% of patients with &gt;1 year of follow-up.

CONCLUSIONS: The PED is effective in the treatment of posterior circulation aneurysms that are otherwise difficult or impossible to treat with standard endovascular or surgical techniques, and its safety is similar to that of stent-assisted coiling techniques. A higher clinical perforator infarction rate may be associated with basilar artery PEDs relative to the internal carotid artery.

mRS
:   modified Rankin Scale
PED
:   Pipeline Embolization Device
SFD
:   Silk flow diverter
TGA
:   Therapeutic Goods Association
WFNS
:   World Federation of Neurological Surgeons" />
<meta name="og-title" property="og:title" content="Safety of the Pipeline Embolization Device in Treatment of Posterior Circulation Aneurysms" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/33/7/1225" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: The published results of treating internal carotid artery aneurysms with the PED do not necessarily apply to its use in the posterior circulation because disabling brain stem infarcts can be caused by occlusion of a single perforator. In this multicenter study, we assessed the safety of PED placement in the posterior circulation.

MATERIALS AND METHODS: A prospective case registry was maintained of all posterior circulation aneurysms treated with PEDs at 3 Australian neurointerventional centers during a 27-month period. The objective was to assess the complications and aneurysm occlusion rates associated with posterior circulation PEDs.

RESULTS: Thirty-two posterior circulation aneurysms were treated in 32 patients. No deaths or poor neurologic outcomes occurred. Perforator territory infarctions occurred in 3 (14%) of the 21 patients with basilar artery aneurysms, and in all 3, a single PED was used. Two asymptomatic intracranial hematomas were recorded. No aneurysm rupture or PED thrombosis was encountered. The overall rate of permanent neurologic complications was 9.4% (3/32); all 3 patients had very mild residual symptoms and a good clinical outcome. Aneurysm occlusion was demonstrated in 85% of patients with &gt;6 months of follow-up and 96% of patients with &gt;1 year of follow-up.

CONCLUSIONS: The PED is effective in the treatment of posterior circulation aneurysms that are otherwise difficult or impossible to treat with standard endovascular or surgical techniques, and its safety is similar to that of stent-assisted coiling techniques. A higher clinical perforator infarction rate may be associated with basilar artery PEDs relative to the internal carotid artery.

mRS
:   modified Rankin Scale
PED
:   Pipeline Embolization Device
SFD
:   Silk flow diverter
TGA
:   Therapeutic Goods Association
WFNS
:   World Federation of Neurological Surgeons" />
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      <h1 class="highwire-cite-title" id="page-title">Safety of the Pipeline Embolization Device in Treatment of Posterior Circulation Aneurysms</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">T.J. Phillips</span>, <span class="highwire-citation-author" data-delta="1">J.D. Wenderoth</span>, <span class="highwire-citation-author" data-delta="2">C.C. Phatouros</span>, <span class="highwire-citation-author" data-delta="3">H. Rice</span>, <span class="highwire-citation-author" data-delta="4">T.P. Singh</span>, <span class="highwire-citation-author" data-delta="5">L. Devilliers</span>, <span class="highwire-citation-author" data-delta="6">V. Wycoco</span>, <span class="highwire-citation-author" data-delta="7">S. Meckel</span> and <span class="highwire-citation-author" data-delta="8">W. McAuliffe</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">August 2012,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">33 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1225-1231; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A3166 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-11996--61018780144" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">T.J. Phillips  </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the Department of Neurological Intervention and Imaging Western Australia (T.J.P., C.C.P., T.P.S., V.W., W.M.), Sir Charles Gairdner Hospital, Perth, Australia</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.J.%2BPhillips%2B%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Phillips%20%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AT.J.%2BPhillips%2B%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">J.D. Wenderoth </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>cNeurointerventional Service (J.D.W.), Prince of Wales Hospital and Liverpool Hospital, Sydney, Australia</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.D.%2BWenderoth%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Wenderoth%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AJ.D.%2BWenderoth%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">C.C. Phatouros </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the Department of Neurological Intervention and Imaging Western Australia (T.J.P., C.C.P., T.P.S., V.W., W.M.), Sir Charles Gairdner Hospital, Perth, Australia</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.C.%2BPhatouros%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Phatouros%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AC.C.%2BPhatouros%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">H. Rice </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>bNeurointerventional Section (H.R., L.D.), Gold Coast Hospital, Surfers Paradise, Queensland, Australia</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=H.%2BRice%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Rice%20H&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AH.%2BRice%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">T.P. Singh </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the Department of Neurological Intervention and Imaging Western Australia (T.J.P., C.C.P., T.P.S., V.W., W.M.), Sir Charles Gairdner Hospital, Perth, Australia</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.P.%2BSingh%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Singh%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AT.P.%2BSingh%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">L. Devilliers </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>bNeurointerventional Section (H.R., L.D.), Gold Coast Hospital, Surfers Paradise, Queensland, Australia</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.%2BDevilliers%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Devilliers%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AL.%2BDevilliers%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">V. Wycoco </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the Department of Neurological Intervention and Imaging Western Australia (T.J.P., C.C.P., T.P.S., V.W., W.M.), Sir Charles Gairdner Hospital, Perth, Australia</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=V.%2BWycoco%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Wycoco%20V&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AV.%2BWycoco%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">S. Meckel </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>dDepartment of Neuroradiology (S.M.), University Hospital Freiburg, Freiberg, Germany.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.%2BMeckel%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Meckel%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AS.%2BMeckel%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">W. 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      <div class="highwire-cite-title">Safety of the Pipeline Embolization Device in Treatment of Posterior Circulation Aneurysms</div>  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Aug 2012, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">33 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1225-1231; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A3166 </span></div>
  
  
  
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