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<meta name="DC.Title" content="Ruptured Intracranial Aneurysms Treated with the Pipeline Embolization Device: A Systematic Review and Pooled Analysis of Individual Patient Data" />
<meta name="DC.Identifier" content="10.3174/ajnr.A7002" />
<meta name="DC.Date" content="2021-04-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND: The Pipeline Embolization Device (PED) is a flow-diverting stent for the treatment of intracranial aneurysms and is used off-label for a subset of ruptured aneurysms not amenable to traditional treatment.

PURPOSE: Our aim was to evaluate the safety and efficacy of the PED for treatment of ruptured intracranial aneurysms.

DATA SOURCES: A systematic review of the MEDLINE, EMBASE, and Scopus data bases from January 2011 to March 2020 was performed for articles reporting treatment of ruptured intracranial aneurysms with the PED.

STUDY SELECTION: A total of 12 studies comprising 145 patients with 145 treated aneurysms were included for analysis.

DATA ANALYSIS: Individual patient data were collected. Nonparametric tests were used to compare differences among patients. Logistic regression was used to determine an association with outcome variables.

DATA SYNTHESIS: Mean aneurysm size was 5.9 mm, and most were blister (51.0%) or dissecting (26.9%) in morphology. Three (2.1%) aneurysms reruptured following PED placement. Univariate logistic regression identified larger aneurysm size as a significant predictor of aneurysm rerupture ( P = .008). Of patients with radiographic follow-up, 87.5% had complete aneurysm occlusion. Symptomatic neurologic complications occurred in 16.5%.

LIMITATIONS: Analysis was limited by the quality of the included data, most of which were from small case series representing class III medical evidence. No study assessed outcome in a blinded or independently adjudicated manner.

CONCLUSIONS: Most ruptured aneurysms treated with the PED were blister or dissecting aneurysms. Treatment was associated with a rerupture rate of 2.1% and a complete occlusion rate of 87.5%.

DAPT
:   dual-antiplatelet therapy
PED
:   Pipeline Embolization Device" />
<meta name="DC.Contributor" content="P.M. Foreman" />
<meta name="DC.Contributor" content="A. Ilyas" />
<meta name="DC.Contributor" content="M.C. Cress" />
<meta name="DC.Contributor" content="J.A. Vachhani" />
<meta name="DC.Contributor" content="R.A. Hirschl" />
<meta name="DC.Contributor" content="B. Agee" />
<meta name="DC.Contributor" content="C.J. Griessenauer" />
<meta name="article:published_time" content="2021-04-01" />
<meta name="article:section" content="Interventional" />
<meta name="citation_title" content="Ruptured Intracranial Aneurysms Treated with the Pipeline Embolization Device: A Systematic Review and Pooled Analysis of Individual Patient Data" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND:&lt;/h3&gt;
&lt;p&gt;The Pipeline Embolization Device (PED) is a flow-diverting stent for the treatment of intracranial aneurysms and is used off-label for a subset of ruptured aneurysms not amenable to traditional treatment.&lt;/p&gt;&lt;h3&gt;PURPOSE:&lt;/h3&gt;
&lt;p&gt;Our aim was to evaluate the safety and efficacy of the PED for treatment of ruptured intracranial aneurysms.&lt;/p&gt;&lt;h3&gt;DATA SOURCES:&lt;/h3&gt;
&lt;p&gt;A systematic review of the MEDLINE, EMBASE, and Scopus data bases from January 2011 to March 2020 was performed for articles reporting treatment of ruptured intracranial aneurysms with the PED.&lt;/p&gt;&lt;h3&gt;STUDY SELECTION:&lt;/h3&gt;
&lt;p&gt;A total of 12 studies comprising 145 patients with 145 treated aneurysms were included for analysis.&lt;/p&gt;&lt;h3&gt;DATA ANALYSIS:&lt;/h3&gt;
&lt;p&gt;Individual patient data were collected. Nonparametric tests were used to compare differences among patients. Logistic regression was used to determine an association with outcome variables.&lt;/p&gt;&lt;h3&gt;DATA SYNTHESIS:&lt;/h3&gt;
&lt;p&gt;Mean aneurysm size was 5.9 mm, and most were blister (51.0%) or dissecting (26.9%) in morphology. Three (2.1%) aneurysms reruptured following PED placement. Univariate logistic regression identified larger aneurysm size as a significant predictor of aneurysm rerupture (&lt;i&gt;P&lt;/i&gt; = .008). Of patients with radiographic follow-up, 87.5% had complete aneurysm occlusion. Symptomatic neurologic complications occurred in 16.5%.&lt;/p&gt;&lt;h3&gt;LIMITATIONS:&lt;/h3&gt;
&lt;p&gt;Analysis was limited by the quality of the included data, most of which were from small case series representing class III medical evidence. No study assessed outcome in a blinded or independently adjudicated manner.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Most ruptured aneurysms treated with the PED were blister or dissecting aneurysms. Treatment was associated with a rerupture rate of 2.1% and a complete occlusion rate of 87.5%.&lt;/p&gt;" />
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<meta name="twitter:title" content="Ruptured Intracranial Aneurysms Treated with the Pipeline Embolization Device: A Systematic Review and Pooled Analysis of Individual Patient Data" />
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<meta name="twitter:image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/42/4.cover-source.jpg" />
<meta name="twitter:description" content="BACKGROUND: The Pipeline Embolization Device (PED) is a flow-diverting stent for the treatment of intracranial aneurysms and is used off-label for a subset of ruptured aneurysms not amenable to traditional treatment.

PURPOSE: Our aim was to evaluate the safety and efficacy of the PED for treatment of ruptured intracranial aneurysms.

DATA SOURCES: A systematic review of the MEDLINE, EMBASE, and Scopus data bases from January 2011 to March 2020 was performed for articles reporting treatment of ruptured intracranial aneurysms with the PED.

STUDY SELECTION: A total of 12 studies comprising 145 patients with 145 treated aneurysms were included for analysis.

DATA ANALYSIS: Individual patient data were collected. Nonparametric tests were used to compare differences among patients. Logistic regression was used to determine an association with outcome variables.

DATA SYNTHESIS: Mean aneurysm size was 5.9 mm, and most were blister (51.0%) or dissecting (26.9%) in morphology. Three (2.1%) aneurysms reruptured following PED placement. Univariate logistic regression identified larger aneurysm size as a significant predictor of aneurysm rerupture ( P = .008). Of patients with radiographic follow-up, 87.5% had complete aneurysm occlusion. Symptomatic neurologic complications occurred in 16.5%.

LIMITATIONS: Analysis was limited by the quality of the included data, most of which were from small case series representing class III medical evidence. No study assessed outcome in a blinded or independently adjudicated manner.

CONCLUSIONS: Most ruptured aneurysms treated with the PED were blister or dissecting aneurysms. Treatment was associated with a rerupture rate of 2.1% and a complete occlusion rate of 87.5%.

DAPT
:   dual-antiplatelet therapy
PED
:   Pipeline Embolization Device" />
<meta name="og-title" property="og:title" content="Ruptured Intracranial Aneurysms Treated with the Pipeline Embolization Device: A Systematic Review and Pooled Analysis of Individual Patient Data" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/42/4/720" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND: The Pipeline Embolization Device (PED) is a flow-diverting stent for the treatment of intracranial aneurysms and is used off-label for a subset of ruptured aneurysms not amenable to traditional treatment.

PURPOSE: Our aim was to evaluate the safety and efficacy of the PED for treatment of ruptured intracranial aneurysms.

DATA SOURCES: A systematic review of the MEDLINE, EMBASE, and Scopus data bases from January 2011 to March 2020 was performed for articles reporting treatment of ruptured intracranial aneurysms with the PED.

STUDY SELECTION: A total of 12 studies comprising 145 patients with 145 treated aneurysms were included for analysis.

DATA ANALYSIS: Individual patient data were collected. Nonparametric tests were used to compare differences among patients. Logistic regression was used to determine an association with outcome variables.

DATA SYNTHESIS: Mean aneurysm size was 5.9 mm, and most were blister (51.0%) or dissecting (26.9%) in morphology. Three (2.1%) aneurysms reruptured following PED placement. Univariate logistic regression identified larger aneurysm size as a significant predictor of aneurysm rerupture ( P = .008). Of patients with radiographic follow-up, 87.5% had complete aneurysm occlusion. Symptomatic neurologic complications occurred in 16.5%.

LIMITATIONS: Analysis was limited by the quality of the included data, most of which were from small case series representing class III medical evidence. No study assessed outcome in a blinded or independently adjudicated manner.

CONCLUSIONS: Most ruptured aneurysms treated with the PED were blister or dissecting aneurysms. Treatment was associated with a rerupture rate of 2.1% and a complete occlusion rate of 87.5%.

DAPT
:   dual-antiplatelet therapy
PED
:   Pipeline Embolization Device" />
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      <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">Ruptured Intracranial Aneurysms Treated with the Pipeline Embolization Device: A Systematic Review and Pooled Analysis of Individual Patient Data</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">P.M. Foreman</span>, <span class="highwire-citation-author" data-delta="1">A. Ilyas</span>, <span class="highwire-citation-author" data-delta="2">M.C. Cress</span>, <span class="highwire-citation-author" data-delta="3">J.A. Vachhani</span>, <span class="highwire-citation-author" data-delta="4">R.A. Hirschl</span>, <span class="highwire-citation-author" data-delta="5">B. Agee</span> and <span class="highwire-citation-author" data-delta="6">C.J. Griessenauer</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">April 2021,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">42 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(4) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">720-725; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A7002 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-90307--61357642757" style="display: none;"><div class="author-tooltip-0"><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'>a</span>From the Neuroscience and Rehabilitation Institute (P.M.F., M.C.C., J.A.V., R.A.H.), Orlando Health, Orlando, Florida</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-1"><div class="author-tooltip-name">A. Ilyas </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Neurosurgery (A.I., B.A.), 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=A.%2BIlyas%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=Ilyas%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.%2BIlyas%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/0000-0002-5545-4398" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. Ilyas</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">M.C. Cress </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Neuroscience and Rehabilitation Institute (P.M.F., M.C.C., J.A.V., R.A.H.), Orlando Health, Orlando, Florida</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.C.%2BCress%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=Cress%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"><a href="/search/author1%3AM.C.%2BCress%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/0000-0001-7510-7775" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M.C. Cress</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">J.A. Vachhani </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Neuroscience and Rehabilitation Institute (P.M.F., M.C.C., J.A.V., R.A.H.), Orlando Health, Orlando, Florida</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.A.%2BVachhani%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=Vachhani%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.A.%2BVachhani%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/0000-0002-2446-4315" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.A. Vachhani</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">R.A. Hirschl </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Neuroscience and Rehabilitation Institute (P.M.F., M.C.C., J.A.V., R.A.H.), Orlando Health, Orlando, Florida</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.%2BHirschl%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=Hirschl%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.A.%2BHirschl%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/0000-0002-0261-7819" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for R.A. Hirschl</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">B. Agee </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Neurosurgery (A.I., B.A.), 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=B.%2BAgee%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=Agee%20B&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%3AB.%2BAgee%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/0000-0003-2128-8448" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for B. 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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">Apr 2021, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">42 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(4) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">720-725; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A7002 </span></div>
  
  
  
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