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<meta name="DC.Title" content="Canadian Experience with the Pipeline Embolization Device for Repair of Unruptured Intracranial Aneurysms" />
<meta name="DC.Identifier" content="10.3174/ajnr.A3224" />
<meta name="DC.Date" content="2013-02-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Flow-diverting stents, such as the PED, have emerged as a novel means of treating complex intracranial aneurysms. This retrospective analysis of the initial Canadian experience provides insight into technical challenges, clinical and radiographic outcomes, and complication rates after the use of flow-diverting stents for unruptured aneurysms.

MATERIALS AND METHODS: Cases were compiled from 7 Canadian centers between July 2008 and December 2010. Each center prospectively tracked their initial experience; these data were retrospectively updated and pooled for analysis.

RESULTS: During the defined study period, 97 cases of unruptured aneurysm were treated with the PED, with successful stent deployment in 94 cases. The overall complete or near-complete occlusion rate was 83%, with a median follow-up at 1.25 years (range 0.25–2.5 years). Progressive occlusion was witnessed over time, with complete or near-complete occlusion in 65% of aneurysms followed through 6 months, and 90% of aneurysms followed through 1 year. Multivariate analysis found previous aneurysm treatment and female sex predictive of persistent aneurysm filling. Most patients were stable or improved (88%), with the most favorable outcomes observed in patients with cavernous carotid aneurysms. The overall mortality rate was 6%. Postprocedural aneurysm hemorrhage occurred in 3 patients (3%), while ipsilateral distal territory hemorrhage was observed in 4 patients (3.4%).

CONCLUSIONS: Flow-diverting stents represent an important tool in the treatment of complex intracranial aneurysms. The relative efficacy and morbidity of this treatment must be considered in the context of available alternate interventions.

ICH
:   intracerebral hemorrhage
PED
:   Pipeline embolization device" />
<meta name="DC.Contributor" content="C.J. O'Kelly" />
<meta name="DC.Contributor" content="J. Spears" />
<meta name="DC.Contributor" content="M. Chow" />
<meta name="DC.Contributor" content="J. Wong" />
<meta name="DC.Contributor" content="M. Boulton" />
<meta name="DC.Contributor" content="A. Weill" />
<meta name="DC.Contributor" content="R.A. Willinsky" />
<meta name="DC.Contributor" content="M. Kelly" />
<meta name="DC.Contributor" content="T.R. Marotta" />
<meta name="article:published_time" content="2013-02-01" />
<meta name="article:section" content="Interventional" />
<meta name="citation_title" content="Canadian Experience with the Pipeline Embolization Device for Repair of Unruptured Intracranial Aneurysms" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Flow-diverting stents, such as the PED, have emerged as a novel means of treating complex intracranial aneurysms. This retrospective analysis of the initial Canadian experience provides insight into technical challenges, clinical and radiographic outcomes, and complication rates after the use of flow-diverting stents for unruptured aneurysms.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Cases were compiled from 7 Canadian centers between July 2008 and December 2010. Each center prospectively tracked their initial experience; these data were retrospectively updated and pooled for analysis.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;During the defined study period, 97 cases of unruptured aneurysm were treated with the PED, with successful stent deployment in 94 cases. The overall complete or near-complete occlusion rate was 83%, with a median follow-up at 1.25 years (range 0.25–2.5 years). Progressive occlusion was witnessed over time, with complete or near-complete occlusion in 65% of aneurysms followed through 6 months, and 90% of aneurysms followed through 1 year. Multivariate analysis found previous aneurysm treatment and female sex predictive of persistent aneurysm filling. Most patients were stable or improved (88%), with the most favorable outcomes observed in patients with cavernous carotid aneurysms. The overall mortality rate was 6%. Postprocedural aneurysm hemorrhage occurred in 3 patients (3%), while ipsilateral distal territory hemorrhage was observed in 4 patients (3.4%).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Flow-diverting stents represent an important tool in the treatment of complex intracranial aneurysms. The relative efficacy and morbidity of this treatment must be considered in the context of available alternate interventions.&lt;/p&gt;" />
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<meta name="twitter:title" content="Canadian Experience with the Pipeline Embolization Device for Repair of Unruptured Intracranial Aneurysms" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Flow-diverting stents, such as the PED, have emerged as a novel means of treating complex intracranial aneurysms. This retrospective analysis of the initial Canadian experience provides insight into technical challenges, clinical and radiographic outcomes, and complication rates after the use of flow-diverting stents for unruptured aneurysms.

MATERIALS AND METHODS: Cases were compiled from 7 Canadian centers between July 2008 and December 2010. Each center prospectively tracked their initial experience; these data were retrospectively updated and pooled for analysis.

RESULTS: During the defined study period, 97 cases of unruptured aneurysm were treated with the PED, with successful stent deployment in 94 cases. The overall complete or near-complete occlusion rate was 83%, with a median follow-up at 1.25 years (range 0.25–2.5 years). Progressive occlusion was witnessed over time, with complete or near-complete occlusion in 65% of aneurysms followed through 6 months, and 90% of aneurysms followed through 1 year. Multivariate analysis found previous aneurysm treatment and female sex predictive of persistent aneurysm filling. Most patients were stable or improved (88%), with the most favorable outcomes observed in patients with cavernous carotid aneurysms. The overall mortality rate was 6%. Postprocedural aneurysm hemorrhage occurred in 3 patients (3%), while ipsilateral distal territory hemorrhage was observed in 4 patients (3.4%).

CONCLUSIONS: Flow-diverting stents represent an important tool in the treatment of complex intracranial aneurysms. The relative efficacy and morbidity of this treatment must be considered in the context of available alternate interventions.

ICH
:   intracerebral hemorrhage
PED
:   Pipeline embolization device" />
<meta name="og-title" property="og:title" content="Canadian Experience with the Pipeline Embolization Device for Repair of Unruptured Intracranial Aneurysms" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/34/2/381" />
<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: Flow-diverting stents, such as the PED, have emerged as a novel means of treating complex intracranial aneurysms. This retrospective analysis of the initial Canadian experience provides insight into technical challenges, clinical and radiographic outcomes, and complication rates after the use of flow-diverting stents for unruptured aneurysms.

MATERIALS AND METHODS: Cases were compiled from 7 Canadian centers between July 2008 and December 2010. Each center prospectively tracked their initial experience; these data were retrospectively updated and pooled for analysis.

RESULTS: During the defined study period, 97 cases of unruptured aneurysm were treated with the PED, with successful stent deployment in 94 cases. The overall complete or near-complete occlusion rate was 83%, with a median follow-up at 1.25 years (range 0.25–2.5 years). Progressive occlusion was witnessed over time, with complete or near-complete occlusion in 65% of aneurysms followed through 6 months, and 90% of aneurysms followed through 1 year. Multivariate analysis found previous aneurysm treatment and female sex predictive of persistent aneurysm filling. Most patients were stable or improved (88%), with the most favorable outcomes observed in patients with cavernous carotid aneurysms. The overall mortality rate was 6%. Postprocedural aneurysm hemorrhage occurred in 3 patients (3%), while ipsilateral distal territory hemorrhage was observed in 4 patients (3.4%).

CONCLUSIONS: Flow-diverting stents represent an important tool in the treatment of complex intracranial aneurysms. The relative efficacy and morbidity of this treatment must be considered in the context of available alternate interventions.

ICH
:   intracerebral hemorrhage
PED
:   Pipeline embolization device" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node853--7" data-node-nid="853" id="top-node-853--81678874204" data-pisa="ajnr;34/2/381" data-pisa-master="ajnr;ajnr.A3224" data-apath="/ajnr/34/2/381.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Interventional</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">Canadian Experience with the Pipeline Embolization Device for Repair of Unruptured Intracranial Aneurysms</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">C.J. O'Kelly</span>, <span class="highwire-citation-author" data-delta="1">J. Spears</span>, <span class="highwire-citation-author" data-delta="2">M. Chow</span>, <span class="highwire-citation-author" data-delta="3">J. Wong</span>, <span class="highwire-citation-author" data-delta="4">M. Boulton</span>, <span class="highwire-citation-author" data-delta="5">A. Weill</span>, <span class="highwire-citation-author" data-delta="6">R.A. Willinsky</span>, <span class="highwire-citation-author" data-delta="7">M. Kelly</span> and <span class="highwire-citation-author" data-delta="8">T.R. Marotta</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">February 2013,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">34 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">381-387; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A3224 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-853--81678874204" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">C.J. O'Kelly </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Division of Neurosurgery (C.J.O., M.C.), Department of Surgery, University of Alberta, Edmonton, Alberta, Canada</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.J.%2BO%27Kelly%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=O%27Kelly%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.J.%2BO%2527Kelly%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. Spears </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Division of Neurosurgery, Department of Surgery (J.S.)</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.%2BSpears%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=Spears%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.%2BSpears%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">M. Chow </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Division of Neurosurgery (C.J.O., M.C.), Department of Surgery, University of Alberta, Edmonton, Alberta, Canada</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=M.%2BChow%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=Chow%20M&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%3AM.%2BChow%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">J. Wong </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Division of Neurosurgery (J.W.), Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada</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.%2BWong%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=Wong%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.%2BWong%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">M. Boulton </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Division of Neurosurgery (M.B.), Department of Surgery, University of Western Ontario, London, Ontario, Canada</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=M.%2BBoulton%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=Boulton%20M&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%3AM.%2BBoulton%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">A. Weill </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>f</span>Department of Radiology (A.W.), University of Montreal, Montreal, Quebec, Canada</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=A.%2BWeill%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=Weill%20A&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%3AA.%2BWeill%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">R.A. Willinsky </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Radiology (R.A.W., T.R.M.), University of Toronto, Toronto, Ontario, Canada</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=R.A.%2BWillinsky%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=Willinsky%20R&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%3AR.A.%2BWillinsky%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">M. Kelly </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>g</span>Division of Neurosurgery, Department of Surgery (M.K.), University of Saskatchewan, Saskatoon, Saskatchewan, Canada.</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=M.%2BKelly%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=Kelly%20M&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%3AM.%2BKelly%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">T.R. 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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">vol. 34 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">no. 2 </span><span  class="highwire-cite-metadata-page-string highwire-cite-metadata">381-387 </span></div>
  
  
  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div xmlns:xhtml="http://www.w3.org/1999/xhtml" class="contributors"><ol class="contributor-list" id="contrib-group-1" compact="none"><li class="contributor" id="contrib-1"><span class="name">C.J. O'Kelly</span><a id="xref-aff-1-1" class="xref-aff" href="#aff-1">a</a>, </li><li class="contributor" id="contrib-2"><span class="name">J. Spears</span><a id="xref-aff-2-1" class="xref-aff" href="#aff-2">b</a>, </li><li class="contributor" id="contrib-3"><span class="name">M. Chow</span><a id="xref-aff-1-2" class="xref-aff" href="#aff-1">a</a>, </li><li class="contributor" id="contrib-4"><span class="name">J. Wong</span><a id="xref-aff-4-1" class="xref-aff" href="#aff-4">d</a>, </li><li class="contributor" id="contrib-5"><span class="name">M. Boulton</span><a id="xref-aff-5-1" class="xref-aff" href="#aff-5">e</a>, </li><li class="contributor" id="contrib-6"><span class="name">A. Weill</span><a id="xref-aff-6-1" class="xref-aff" href="#aff-6">f</a>, </li><li class="contributor" id="contrib-7"><span class="name">R.A. Willinsky</span><a id="xref-aff-3-1" class="xref-aff" href="#aff-3">c</a>, </li><li class="contributor" id="contrib-8"><span class="name">M. Kelly</span><a id="xref-aff-7-1" class="xref-aff" href="#aff-7">g</a> and </li><li class="last" id="contrib-9"><span class="name">T.R. Marotta</span><a id="xref-aff-3-2" class="xref-aff" href="#aff-3">c</a></li></ol><ol class="affiliation-list" compact="none"><li class="aff"><a id="aff-1" name="aff-1"></a><address><sup>a</sup>From the Division of Neurosurgery (C.J.O., M.C.), Department of Surgery, University of Alberta, Edmonton, Alberta, Canada</address></li><li class="aff"><a id="aff-2" name="aff-2"></a><address><sup>b</sup>Division of Neurosurgery, Department of Surgery (J.S.)</address></li><li class="aff"><a id="aff-3" name="aff-3"></a><address><sup>c</sup>Department of Radiology (R.A.W., T.R.M.), University of Toronto, Toronto, Ontario, Canada</address></li><li class="aff"><a id="aff-4" name="aff-4"></a><address><sup>d</sup>Division of Neurosurgery (J.W.), Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada</address></li><li class="aff"><a id="aff-5" name="aff-5"></a><address><sup>e</sup>Division of Neurosurgery (M.B.), Department of Surgery, University of Western Ontario, London, Ontario, Canada</address></li><li class="aff"><a id="aff-6" name="aff-6"></a><address><sup>f</sup>Department of Radiology (A.W.), University of Montreal, Montreal, Quebec, Canada</address></li><li class="aff"><a id="aff-7" name="aff-7"></a><address><sup>g</sup>Division of Neurosurgery, Department of Surgery (M.K.), University of Saskatchewan, Saskatoon, Saskatchewan, Canada.</address></li></ol><ol class="corresp-list" compact="none"><li class="corresp" id="corresp-1">Please address correspondence to Dr. Cian J. O'Kelly, <span class="addr-line">2D1.02 Mackenzie Centre, 8440-112 St, Edmonton, Alberta, Canada, T6G 2B7</span>; e-mail: <span class="em-link"><span class="em-addr">cian.okelly{at}albertahealthservices.ca</span></span></li></ol></div></div><a href="http://ajnr-stage2.stage.highwire.org/content/34/2/381.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 34</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 2 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Feb 2013 </div></div>
      
      
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