Multicenter Study of Pipeline Flex for Intracranial Aneurysms

Multicenter Study of Pipeline Flex for Intracranial Aneurysms

Abstract Background The Pipeline Flex (PED Flex; Medtronic, Dublin, Ireland) was designed to facilitate deployment and navigation compared to its previous iteration to reduce the rate of technical events and complications. OBJECTIVE To assess the neurological morbidity and mortality rates of the PED...

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Bibliographic Details
Published in:Neurosurgery Vol. 84; no. 6; pp. E402 - E409
Main Authors: Brasiliense, Leonardo B C, Aguilar-Salinas, Pedro, Lopes, Demetrius K, Nogueira, Danilo, DeSousa, Keith, Nelson, Peter K, Moran, Christopher J, Mazur, Marcus D, Taussky, Philipp, Park, Min S, Dabus, Guilherme, Linfante, Italo, Chaudry, Imran, Turner, Ray D, Spiotta, Alex M, Turk, Aquilla S, Siddiqui, Adnan H, Levy, Elad I, Hopkins, L Nelson, Arthur, Adam S, Nickele, Christopher, Gonsales, Douglas, Sauvageau, Eric, Hanel, Ricardo A
Format: Journal Article
Language:English
Published: United States Oxford University Press 01-06-2019
Copyright by the Congress of Neurological Surgeons
Wolters Kluwer Health, Inc
Subjects:
Adult
Aged
Aneurysms
Angiography
Comparative analysis
Diagnosis
Female
Humans
Intracranial Aneurysm - mortality
Intracranial Aneurysm - surgery
Logistic Models
Male
Middle Aged
Morbidity
Mortality
Multivariate Analysis
Neurosurgery
Patient Discharge
Retrospective Studies
Stroke
Treatment Outcome
Young Adult
Ireland
Embolization
Stroke
Endovascular
Aneurysm
Pipeline
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Summary:Abstract Background The Pipeline Flex (PED Flex; Medtronic, Dublin, Ireland) was designed to facilitate deployment and navigation compared to its previous iteration to reduce the rate of technical events and complications. OBJECTIVE To assess the neurological morbidity and mortality rates of the PED Flex at 30 d. Methods Information from 9 neurovascular centers was retrospectively obtained between July 2014 and March 2016. Data included patient/aneurysm characteristics, periprocedural events, clinical, and angiographic outcomes. Multivariate logistic regression was performed to determine predictors of unfavorable clinical outcome (modified Rankin Scale [mRS] > 2). Results A total of 205 patients harboring 223 aneurysms were analyzed. The 30-d neurological morbidity and mortality rates were 1.9% (4/205) and 0.5% (1/205), respectively. The rate of intraprocedural events without neurological morbidity was 6.8% (14/205), consisting of intraprocedural ischemic events in 9 patients (4.5%) and hemorrhage in 5 (2.4%). Other technical events included difficulty capturing the delivery wire in 1 case (0.5%) and device migration after deployment in another case (0.5%). Favorable clinical outcome (mRS 0-2) was achieved in 186 patients (94.4%) at discharge and in 140 patients (94.5%) at 30 d. We did not find predictors of clinical outcomes on multivariate analysis. Conclusion The 30-d rates of neurological morbidity and mortality in this multicenter cohort using the PED Flex for the treatment of intracranial aneurysms were low, 1.9% (4/205) and 0.5% (1/205), respectively. In addition, technical events related to device deployment were also low, most likely due to the latest modifications in the delivery system.
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ISSN:0148-396X
1524-4040
DOI:10.1093/neuros/nyy422