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<meta name="DC.Title" content="Risk of Branch Occlusion and Ischemic Complications with the Pipeline Embolization Device in the Treatment of Posterior Circulation Aneurysms" />
<meta name="DC.Identifier" content="10.3174/ajnr.A5696" />
<meta name="DC.Date" content="2018-07-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2018 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Flow diversion with the Pipeline Embolization Device is increasingly used for endovascular treatment of intracranial aneurysms due to high reported obliteration rates and low associated morbidity. While obliteration of covered branches in the anterior circulation is generally asymptomatic, this has not been studied within the posterior circulation. The aim of this study was to evaluate the association between branch coverage and occlusion, as well as associated ischemic events in a cohort of patients with posterior circulation aneurysms treated with the Pipeline Embolization Device.

MATERIALS AND METHODS: A retrospective review of prospectively maintained databases at 8 academic institutions from 2009 to 2016 was performed to identify patients with posterior circulation aneurysms treated with the Pipeline Embolization Device. Branch coverage following placement was evaluated, including the posterior inferior cerebellar artery, anterior inferior cerebellar artery, superior cerebellar artery, and posterior cerebral artery. If the Pipeline Embolization Device crossed the ostia of the contralateral vertebral artery, its long-term patency was assessed as well.

RESULTS: A cohort of 129 consecutive patients underwent treatment of 131 posterior circulation aneurysms with the Pipeline Embolization Device. Adjunctive coiling was used in 40 (31.0%) procedures. One or more branches were covered in 103 (79.8%) procedures. At a median follow-up of 11 months, 11% were occluded, most frequently the vertebral artery (34.8%). Branch obliteration was most common among asymptomatic aneurysms ( P &lt; .001). Ischemic complications occurred in 29 (22.5%) procedures. On multivariable analysis, there was no significant difference in ischemic complications in cases in which a branch was covered ( P = .24) or occluded ( P = .16).

CONCLUSIONS: There was a low occlusion incidence in end arteries following branch coverage at last follow-up. The incidence was higher in the posterior cerebral artery and vertebral artery where collateral supply is high. Branch occlusion was not associated with a significant increase in ischemic complications.

PCA
:   posterior cerebral artery
PED
:   Pipeline Embolization Device
VA
:   vertebral artery" />
<meta name="DC.Contributor" content="N. Adeeb" />
<meta name="DC.Contributor" content="C.J. Griessenauer" />
<meta name="DC.Contributor" content="A.A. Dmytriw" />
<meta name="DC.Contributor" content="H. Shallwani" />
<meta name="DC.Contributor" content="R. Gupta" />
<meta name="DC.Contributor" content="P.M. Foreman" />
<meta name="DC.Contributor" content="H. Shakir" />
<meta name="DC.Contributor" content="J. Moore" />
<meta name="DC.Contributor" content="N. Limbucci" />
<meta name="DC.Contributor" content="S. Mangiafico" />
<meta name="DC.Contributor" content="A. Kumar" />
<meta name="DC.Contributor" content="C. Michelozzi" />
<meta name="DC.Contributor" content="Y. Zhang" />
<meta name="DC.Contributor" content="V.M. Pereira" />
<meta name="DC.Contributor" content="C.C. Matouk" />
<meta name="DC.Contributor" content="M.R. Harrigan" />
<meta name="DC.Contributor" content="A.H. Siddiqui" />
<meta name="DC.Contributor" content="E.I. Levy" />
<meta name="DC.Contributor" content="L. Renieri" />
<meta name="DC.Contributor" content="T.R. Marotta" />
<meta name="DC.Contributor" content="C. Cognard" />
<meta name="DC.Contributor" content="C.S. Ogilvy" />
<meta name="DC.Contributor" content="A.J. Thomas" />
<meta name="article:published_time" content="2018-07-01" />
<meta name="article:section" content="Interventional" />
<meta name="citation_title" content="Risk of Branch Occlusion and Ischemic Complications with the Pipeline Embolization Device in the Treatment of Posterior Circulation Aneurysms" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Flow diversion with the Pipeline Embolization Device is increasingly used for endovascular treatment of intracranial aneurysms due to high reported obliteration rates and low associated morbidity. While obliteration of covered branches in the anterior circulation is generally asymptomatic, this has not been studied within the posterior circulation. The aim of this study was to evaluate the association between branch coverage and occlusion, as well as associated ischemic events in a cohort of patients with posterior circulation aneurysms treated with the Pipeline Embolization Device.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;A retrospective review of prospectively maintained databases at 8 academic institutions from 2009 to 2016 was performed to identify patients with posterior circulation aneurysms treated with the Pipeline Embolization Device. Branch coverage following placement was evaluated, including the posterior inferior cerebellar artery, anterior inferior cerebellar artery, superior cerebellar artery, and posterior cerebral artery. If the Pipeline Embolization Device crossed the ostia of the contralateral vertebral artery, its long-term patency was assessed as well.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;A cohort of 129 consecutive patients underwent treatment of 131 posterior circulation aneurysms with the Pipeline Embolization Device. Adjunctive coiling was used in 40 (31.0%) procedures. One or more branches were covered in 103 (79.8%) procedures. At a median follow-up of 11 months, 11% were occluded, most frequently the vertebral artery (34.8%). Branch obliteration was most common among asymptomatic aneurysms (&lt;i&gt;P&lt;/i&gt; &amp;lt; .001). Ischemic complications occurred in 29 (22.5%) procedures. On multivariable analysis, there was no significant difference in ischemic complications in cases in which a branch was covered (&lt;i&gt;P&lt;/i&gt; = .24) or occluded (&lt;i&gt;P&lt;/i&gt; = .16).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;There was a low occlusion incidence in end arteries following branch coverage at last follow-up. The incidence was higher in the posterior cerebral artery and vertebral artery where collateral supply is high. Branch occlusion was not associated with a significant increase in ischemic complications.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
<meta name="citation_publisher" content="American Journal of Neuroradiology" />
<meta name="citation_publication_date" content="2018/07/01" />
<meta name="citation_mjid" content="ajnr;39/7/1303" />
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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.A5696" />
<meta name="citation_pmid" content="29880475" />
<meta name="citation_volume" content="39" />
<meta name="citation_issue" content="7" />
<meta name="citation_article_type" content="Research Article" />
<meta name="citation_section" content="Interventional" />
<meta name="citation_firstpage" content="1303" />
<meta name="citation_lastpage" content="1309" />
<meta name="citation_author" content="N. Adeeb" />
<meta name="citation_author_institution" content="aFrom the Beth Israel Deaconess Medical Center (N.A., C.J.G., A.A.D., R.G., J.M., C.S.O., A.J.T.), Harvard Medical School, Boston, Massachusetts" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-8668-7629" />
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<meta name="twitter:title" content="Risk of Branch Occlusion and Ischemic Complications with the Pipeline Embolization Device in the Treatment of Posterior Circulation Aneurysms" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Flow diversion with the Pipeline Embolization Device is increasingly used for endovascular treatment of intracranial aneurysms due to high reported obliteration rates and low associated morbidity. While obliteration of covered branches in the anterior circulation is generally asymptomatic, this has not been studied within the posterior circulation. The aim of this study was to evaluate the association between branch coverage and occlusion, as well as associated ischemic events in a cohort of patients with posterior circulation aneurysms treated with the Pipeline Embolization Device.

MATERIALS AND METHODS: A retrospective review of prospectively maintained databases at 8 academic institutions from 2009 to 2016 was performed to identify patients with posterior circulation aneurysms treated with the Pipeline Embolization Device. Branch coverage following placement was evaluated, including the posterior inferior cerebellar artery, anterior inferior cerebellar artery, superior cerebellar artery, and posterior cerebral artery. If the Pipeline Embolization Device crossed the ostia of the contralateral vertebral artery, its long-term patency was assessed as well.

RESULTS: A cohort of 129 consecutive patients underwent treatment of 131 posterior circulation aneurysms with the Pipeline Embolization Device. Adjunctive coiling was used in 40 (31.0%) procedures. One or more branches were covered in 103 (79.8%) procedures. At a median follow-up of 11 months, 11% were occluded, most frequently the vertebral artery (34.8%). Branch obliteration was most common among asymptomatic aneurysms ( P &lt; .001). Ischemic complications occurred in 29 (22.5%) procedures. On multivariable analysis, there was no significant difference in ischemic complications in cases in which a branch was covered ( P = .24) or occluded ( P = .16).

CONCLUSIONS: There was a low occlusion incidence in end arteries following branch coverage at last follow-up. The incidence was higher in the posterior cerebral artery and vertebral artery where collateral supply is high. Branch occlusion was not associated with a significant increase in ischemic complications.

PCA
:   posterior cerebral artery
PED
:   Pipeline Embolization Device
VA
:   vertebral artery" />
<meta name="og-title" property="og:title" content="Risk of Branch Occlusion and Ischemic Complications with the Pipeline Embolization Device in the Treatment of Posterior Circulation Aneurysms" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/39/7/1303" />
<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 diversion with the Pipeline Embolization Device is increasingly used for endovascular treatment of intracranial aneurysms due to high reported obliteration rates and low associated morbidity. While obliteration of covered branches in the anterior circulation is generally asymptomatic, this has not been studied within the posterior circulation. The aim of this study was to evaluate the association between branch coverage and occlusion, as well as associated ischemic events in a cohort of patients with posterior circulation aneurysms treated with the Pipeline Embolization Device.

MATERIALS AND METHODS: A retrospective review of prospectively maintained databases at 8 academic institutions from 2009 to 2016 was performed to identify patients with posterior circulation aneurysms treated with the Pipeline Embolization Device. Branch coverage following placement was evaluated, including the posterior inferior cerebellar artery, anterior inferior cerebellar artery, superior cerebellar artery, and posterior cerebral artery. If the Pipeline Embolization Device crossed the ostia of the contralateral vertebral artery, its long-term patency was assessed as well.

RESULTS: A cohort of 129 consecutive patients underwent treatment of 131 posterior circulation aneurysms with the Pipeline Embolization Device. Adjunctive coiling was used in 40 (31.0%) procedures. One or more branches were covered in 103 (79.8%) procedures. At a median follow-up of 11 months, 11% were occluded, most frequently the vertebral artery (34.8%). Branch obliteration was most common among asymptomatic aneurysms ( P &lt; .001). Ischemic complications occurred in 29 (22.5%) procedures. On multivariable analysis, there was no significant difference in ischemic complications in cases in which a branch was covered ( P = .24) or occluded ( P = .16).

CONCLUSIONS: There was a low occlusion incidence in end arteries following branch coverage at last follow-up. The incidence was higher in the posterior cerebral artery and vertebral artery where collateral supply is high. Branch occlusion was not associated with a significant increase in ischemic complications.

PCA
:   posterior cerebral artery
PED
:   Pipeline Embolization Device
VA
:   vertebral artery" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node61686--5" data-node-nid="61686" id="top-node-61686--61396956589" data-pisa="ajnr;39/7/1303" data-pisa-master="ajnr;ajnr.A5696" data-apath="/ajnr/39/7/1303.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">Risk of Branch Occlusion and Ischemic Complications with the Pipeline Embolization Device in the 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">N. Adeeb</span>, <span class="highwire-citation-author" data-delta="1">C.J. Griessenauer</span>, <span class="highwire-citation-author" data-delta="2">A.A. Dmytriw</span>, <span class="highwire-citation-author" data-delta="3">H. Shallwani</span>, <span class="highwire-citation-author" data-delta="4">R. Gupta</span>, <span class="highwire-citation-author" data-delta="5">P.M. Foreman</span>, <span class="highwire-citation-author" data-delta="6">H. Shakir</span>, <span class="highwire-citation-author" data-delta="7">J. Moore</span>, <span class="highwire-citation-author" data-delta="8">N. Limbucci</span>, <span class="highwire-citation-author" data-delta="9">S. Mangiafico</span>, <span class="highwire-citation-author" data-delta="10">A. Kumar</span>, <span class="highwire-citation-author" data-delta="11">C. Michelozzi</span>, <span class="highwire-citation-author" data-delta="12">Y. Zhang</span>, <span class="highwire-citation-author" data-delta="13">V.M. Pereira</span>, <span class="highwire-citation-author" data-delta="14">C.C. Matouk</span>, <span class="highwire-citation-author" data-delta="15">M.R. Harrigan</span>, <span class="highwire-citation-author" data-delta="16">A.H. Siddiqui</span>, <span class="highwire-citation-author" data-delta="17">E.I. Levy</span>, <span class="highwire-citation-author" data-delta="18">L. Renieri</span>, <span class="highwire-citation-author" data-delta="19">T.R. Marotta</span>, <span class="highwire-citation-author" data-delta="20">C. Cognard</span>, <span class="highwire-citation-author" data-delta="21">C.S. Ogilvy</span> and <span class="highwire-citation-author" data-delta="22">A.J. Thomas</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">July 2018,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">39 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1303-1309; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A5696 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-61686--61396956589" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">N. Adeeb </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Beth Israel Deaconess Medical Center (N.A., C.J.G., A.A.D., R.G., J.M., C.S.O., A.J.T.), Harvard Medical School, Boston, Massachusetts</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=N.%2BAdeeb%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=Adeeb%20N&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"><a href="/search/author1%3AN.%2BAdeeb%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-8668-7629" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for N. Adeeb</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">C.J. Griessenauer </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Beth Israel Deaconess Medical Center (N.A., C.J.G., A.A.D., R.G., J.M., C.S.O., A.J.T.), Harvard Medical School, Boston, Massachusetts</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Neurosurgery (C.J.G.), Geisinger Medical Center, Geisinger Commonwealth School of Medicine, Danville, Pennsylvania</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.%2BGriessenauer%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=Griessenauer%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"><a href="/search/author1%3AC.J.%2BGriessenauer%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-2952-3812" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C.J. Griessenauer</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">A.A. Dmytriw </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Beth Israel Deaconess Medical Center (N.A., C.J.G., A.A.D., R.G., J.M., C.S.O., A.J.T.), Harvard Medical School, Boston, Massachusetts</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Medical Imaging (A.A.D., Y.Z., V.M.P.), Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada</div><div class='author-affiliation'><span class='nlm-sup'>d</span>Division of Diagnostic and Therapeutic Neuroradiology (A.A.D., A.K., T.R.M.), St. Michael's Hospital, 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=A.A.%2BDmytriw%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=Dmytriw%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"><a href="/search/author1%3AA.A.%2BDmytriw%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-0131-5699" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A.A. Dmytriw</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">H. Shallwani </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Department of Neurosurgery (H. Shallwani, H. Shakir, A.H.S., E.I.L.), State University of New York at Buffalo, Buffalo, New York</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.%2BShallwani%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=Shallwani%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"><a href="/search/author1%3AH.%2BShallwani%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-9481-3082" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for H. Shallwani</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">R. Gupta </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Beth Israel Deaconess Medical Center (N.A., C.J.G., A.A.D., R.G., J.M., C.S.O., A.J.T.), Harvard Medical School, Boston, Massachusetts</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.%2BGupta%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=Gupta%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"><a href="/search/author1%3AR.%2BGupta%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-5497-3241" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for R. Gupta</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">P.M. Foreman </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>f</span>Department of Neurosurgery (P.M.F., M.R.H.), University of Alabama at Birmingham, Birmingham, Alabama</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=P.M.%2BForeman%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=Foreman%20P&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"><a href="/search/author1%3AP.M.%2BForeman%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-8743-5119" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P.M. Foreman</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">H. Shakir </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Department of Neurosurgery (H. Shallwani, H. Shakir, A.H.S., E.I.L.), State University of New York at Buffalo, Buffalo, New York</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.%2BShakir%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=Shakir%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"><a href="/search/author1%3AH.%2BShakir%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-4234-340X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for H. Shakir</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">J. Moore </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Beth Israel Deaconess Medical Center (N.A., C.J.G., A.A.D., R.G., J.M., C.S.O., A.J.T.), Harvard Medical School, Boston, Massachusetts</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.%2BMoore%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=Moore%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"><a href="/search/author1%3AJ.%2BMoore%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-2385-6357" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J. Moore</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">N. Limbucci </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>g</span>Department of Interventional Neuroradiology (N.L., S.M., L.R.), University of Florence, Florence, Italy</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=N.%2BLimbucci%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=Limbucci%20N&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"><a href="/search/author1%3AN.%2BLimbucci%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-0432-5414" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for N. Limbucci</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">S. Mangiafico </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>g</span>Department of Interventional Neuroradiology (N.L., S.M., L.R.), University of Florence, Florence, Italy</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.%2BMangiafico%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=Mangiafico%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"><a href="/search/author1%3AS.%2BMangiafico%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-9102-0220" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S. Mangiafico</a></li></ul></div><div class="author-tooltip-10"><div class="author-tooltip-name">A. Kumar </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Division of Diagnostic and Therapeutic Neuroradiology (A.A.D., A.K., T.R.M.), St. Michael's Hospital, 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=A.%2BKumar%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=Kumar%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"><a href="/search/author1%3AA.%2BKumar%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-3755-1917" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. Kumar</a></li></ul></div><div class="author-tooltip-11"><div class="author-tooltip-name">C. Michelozzi </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>h</span>Department of Diagnostic and Therapeutic Neuroradiology (C.M., C.C.), Toulouse University Hospital, Toulouse, France</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.%2BMichelozzi%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=Michelozzi%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"><a href="/search/author1%3AC.%2BMichelozzi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-6339-448X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C. Michelozzi</a></li></ul></div><div class="author-tooltip-12"><div class="author-tooltip-name">Y. Zhang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Medical Imaging (A.A.D., Y.Z., V.M.P.), Toronto Western Hospital, University Health Network, 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=Y.%2BZhang%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=Zhang%20Y&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"><a href="/search/author1%3AY.%2BZhang%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-5076-8224" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Y. Zhang</a></li></ul></div><div class="author-tooltip-13"><div class="author-tooltip-name">V.M. 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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 39</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 7 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Jul 2018 </div></div>
      
      
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      <div class="highwire-cite-title">Risk of Branch Occlusion and Ischemic Complications with the Pipeline Embolization Device in the Treatment of Posterior Circulation Aneurysms</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">N.</span> <span class="nlm-surname">Adeeb</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">C.J.</span> <span class="nlm-surname">Griessenauer</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">A.A.</span> <span class="nlm-surname">Dmytriw</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">H.</span> <span class="nlm-surname">Shallwani</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Gupta</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">P.M.</span> <span class="nlm-surname">Foreman</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">H.</span> <span class="nlm-surname">Shakir</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Moore</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">N.</span> <span class="nlm-surname">Limbucci</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Mangiafico</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Kumar</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Michelozzi</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-given-names">Y.</span> <span class="nlm-surname">Zhang</span></span>, <span class="highwire-citation-author" data-delta="13"><span class="nlm-given-names">V.M.</span> <span class="nlm-surname">Pereira</span></span>, <span class="highwire-citation-author" data-delta="14"><span class="nlm-given-names">C.C.</span> <span class="nlm-surname">Matouk</span></span>, <span class="highwire-citation-author" data-delta="15"><span class="nlm-given-names">M.R.</span> <span class="nlm-surname">Harrigan</span></span>, <span class="highwire-citation-author" data-delta="16"><span class="nlm-given-names">A.H.</span> <span class="nlm-surname">Siddiqui</span></span>, <span class="highwire-citation-author" data-delta="17"><span class="nlm-given-names">E.I.</span> <span class="nlm-surname">Levy</span></span>, <span class="highwire-citation-author" data-delta="18"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Renieri</span></span>, <span class="highwire-citation-author" data-delta="19"><span class="nlm-given-names">T.R.</span> <span class="nlm-surname">Marotta</span></span>, <span class="highwire-citation-author" data-delta="20"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Cognard</span></span>, <span class="highwire-citation-author" data-delta="21"><span class="nlm-given-names">C.S.</span> <span class="nlm-surname">Ogilvy</span></span>, <span class="highwire-citation-author" data-delta="22"><span class="nlm-given-names">A.J.</span> <span class="nlm-surname">Thomas</span></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">Jul 2018, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">39 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1303-1309; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5696 </span></div>
  
  
  
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      <div class="highwire-cite-title">Risk of Branch Occlusion and Ischemic Complications with the Pipeline Embolization Device in the Treatment of Posterior Circulation Aneurysms</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">N.</span> <span class="nlm-surname">Adeeb</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">C.J.</span> <span class="nlm-surname">Griessenauer</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">A.A.</span> <span class="nlm-surname">Dmytriw</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">H.</span> <span class="nlm-surname">Shallwani</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Gupta</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">P.M.</span> <span class="nlm-surname">Foreman</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">H.</span> <span class="nlm-surname">Shakir</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Moore</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">N.</span> <span class="nlm-surname">Limbucci</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Mangiafico</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Kumar</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Michelozzi</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-given-names">Y.</span> <span class="nlm-surname">Zhang</span></span>, <span class="highwire-citation-author" data-delta="13"><span class="nlm-given-names">V.M.</span> <span class="nlm-surname">Pereira</span></span>, <span class="highwire-citation-author" data-delta="14"><span class="nlm-given-names">C.C.</span> <span class="nlm-surname">Matouk</span></span>, <span class="highwire-citation-author" data-delta="15"><span class="nlm-given-names">M.R.</span> <span class="nlm-surname">Harrigan</span></span>, <span class="highwire-citation-author" data-delta="16"><span class="nlm-given-names">A.H.</span> <span class="nlm-surname">Siddiqui</span></span>, <span class="highwire-citation-author" data-delta="17"><span class="nlm-given-names">E.I.</span> <span class="nlm-surname">Levy</span></span>, <span class="highwire-citation-author" data-delta="18"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Renieri</span></span>, <span class="highwire-citation-author" data-delta="19"><span class="nlm-given-names">T.R.</span> <span class="nlm-surname">Marotta</span></span>, <span class="highwire-citation-author" data-delta="20"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Cognard</span></span>, <span class="highwire-citation-author" data-delta="21"><span class="nlm-given-names">C.S.</span> <span class="nlm-surname">Ogilvy</span></span>, <span class="highwire-citation-author" data-delta="22"><span class="nlm-given-names">A.J.</span> <span class="nlm-surname">Thomas</span></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">Jul 2018, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">39 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1303-1309; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5696 </span></div>
  
  
  
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