Endovascular treatment of unruptured aneurysms of cavernous and ophtalmic segment of internal carotid artery with flow diverter device Pipeline

Abstract

Abstract

Background and Purpose:

Intra-arterial treatment of aneurysms by redirecting blood flow is a recent method, where the redirection is based on a significantly more densely braided wire stent. The advantage of using a stent wall is that it keeps the blood in the lumen of the stent and slows down the turbulent flow in the aneurysms. The stagnation of blood in the aneurysm sac leads to the formation of thrombus and subsequent exclusion of the aneurysm from the circulation.

Methods:

The following study evaluates the flow diverter device Pipeline for broad neck and giant aneurysm treatment. 15 patients with discovered aneurysm of the internal carotid artery were treated between November 2010 and February 2014. The majority of aneurysms of the internal carotid artery were located intra-dural at the ophthalmic part of the artery. The patients were treated using a flow diverter device Pipeline, which was placed over the aneurysm neck. Treatment success was assessed clinically and angiographically using O'Kelly Marotta scale.

Results:

Control angiography immediately after the release of the stent showed stagnation of the blood flow in the aneurysm sac. For none of the patients we observed procedural and periprocedural complications. 6 months after the procedure, control CT or MR angiography showed in almost all cases exclusion of the aneurysm from the circulation and normal blood flow in the treated artery. Neurological status six months after the procedure was normal in all patients.

Conclusion:

Based on evidence presented, we find that treatment of aneurysms with a flow diverter device is a safe and significantly more efficient method in comparison to standard techniques, and is a promising approach in treatment of broad neck aneurysms.