Skip to main content
  • Doppler Ultrasound for Follow up of the Pipeline Embolization Device

    Final Number:

    Cameron Michael McDougall MD; Kurshid Khan MD, FRCP(C); Maher Saqqur MD, FRCP(C); Andrew Jack MD; Jeremy Rempel MD FRCS(C); Carol Derksen RN, RVT; Michael M. Chow MD

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2013 Annual Meeting

    Introduction: The Pipeline embolization device (PED) is a relatively new device used to treat complex aneurysms. The optimal method of radiographic follow up for patients treated with the PED has not been established. The rate of in-stent stenosis is unknown. We evaluate the use of trans cranial doppler ultrasound (TCD) for detecting in-stent stenosis.

    Methods: We analyzed 28 patients treated with the PED over the course of 42 months from January 2009 to June 2012. A standard conventional cerebral angiogram was preformed in all patients. TCD studies were available in 22 patients.

    Results: Angiographic and US results were compared and found to be highly correlative (P<0.001)

    Conclusions: TCD is a potentially useful adjunct for evaluating in-stent stenosis of the PED.

    Patient Care: By decreasing the need for repeat cerebral angiography in patients with the pipeline embolization device.

    Learning Objectives: The learner will be able to describe the potential role of doppler ultrasound as it applies to long term follow up of the the Pipeline Embolization Device.

    References: 1. Fiorella D LP, Szikora I, Kelly ME, Albuquerque FC, McDougall CG, Nelson PK. Curative cerebrovascular reconstruction with the Pipeline embolization device: the emergence of definitive endovascular therapy for intracranial aneurysms. J Neurointerv Surg 2009;1:56-65 2. Deutschmann HA WM, Augustin M, Niederkorn K, Klein GE Long-Term Follow-Up after Treatment of Intracranial Aneurysms with the Pipeline Embolization Device: Results from a Single Center. AJNR 2011;0195-6108 3. Chow M MC, O'Kelly C, Ashforth R, Johnson E, Fiorella D. Delayed Spontaneous Rupture of a posterior inferior cerebellar artery aneurysm following treatment with flow diversion: A clinicopathologic study. AJNR 2001 4. Martin A CJ, Matouk C, Spears J, Marotta T. The Pipeline Flow-Diverting Stent for Exclusion of Ruptured Intracranial Aneurysms With Difficult Morphologies. Operative Neurosurgery 2012;70 5. Fiorella D WH, Albuquerque FC, Nelson PK. Definitive reconstruction of circumferential, fusiform intracranial aneurysms with the pipeline embolization device. Neurosurgery 2008;62:1115-1120 6. Brinjikji W CH, Fiorella D, Lanzino G, Kallmes DF. Estimating the proportion of intracranial aneurysms likely to be amenable to treatment with the pipeline embolization device. J Neurointerv Surg 2011 7. Lubicz B CL, Raphaeli G, De Witte O. Pipeline flow-diverter stent for endovascular treatment of intracranial aneurysms: preliminary experience in 20 patients with 27 aneurysms. World Neurosurg 2011;76:114-119 8. Nelson PK LP, Szikora I, Wetzel SG, Wanke I, Fiorella D. The pipeline embolization device for the intracranial treatment of aneurysms trial. AJNR 2011;32:34-40 9. Lylyk P MC, Ceratto R, Ferrario A, Scrivano E, Luna HR, Berez Al, Tran Q, Nelson PK, Fiorella D. Curative endovascular reconstruction of cerebral aneurysms with the pipeline embolization device: the Buenos Aires experience. Neurosurgery 2009;64:642-643 10. McAuliffe W WV, Rice H, Phatouros C, Singh TJ, Wenderoth J. Immediate and midterm results following treatment of unruptured intracranial aneurysms with the pipeline embolization device. AJNR 2012;33:164-170 11. Golshani B LM, Raslau F, Ziad D, Dhiraj B, Eastwood D, Fitzsimmons B, Zaidat O. Surveillance imagiing after intracranial stent implantation: non-invasive imaging compared with digital subtraction angiography. J Neurointerv Surg 2012 12. Abou-chebl A BQ, Yadav J. Drug-eluting stents for the treatment of intracranial atherosclerosis: inintal experience and midterm angiographic follow-up. Stroke 2005;36:e165-168 13. Moreira T MP, Binaghi S, Hirt L. Risk factor impact on blood flow velocities and clinical outcomes of stented cervical and intracranial stensoses:Preliminary observations. Clin Neurol Neurosurg 2012 14. Fifi JT MP, Lavine SD, et al. Complications of modern diagnostic cerebral angiography in an academic medical center. J Vasc Interv Radiol 2009;20:442-447 15. Cloft HJ JG, Dion JE. Risk of cerebral angiography in patients with subarchnoid hemorrhage, cerebral aneurysm and arteriovenous malformation: a meta-analysis. . Stroke 1999;30:317-320 16. Aaslid R HP, Nornes H Evaluation of cerebrovascular spasm with transcranial Doppler ultrasound. J Neurosurg 1984;60:37-41 17. Mascia L FL, terBrugge K, Filippini C, Pizzio M, Ranieri VM, Wallace MC. The accuracy of transcranial doppler to detect vasospasm in patients with aneruysmal subarachnoid hemorrhage. Intensive Care Med 2003;29:1088-1094 18. Nedelmann M SE, Baumgartner RW, Malferrari G, Seidel G, Kaps M, TCCS consensus Group. Consensus recommendations for transcranial color-coded duplex sonography for the assessment of intracranial arteries in clinical trials on acute stroke. Stroke 2009;40:3238-3244

We use cookies to improve the performance of our site, to analyze the traffic to our site, and to personalize your experience of the site. You can control cookies through your browser settings. Please find more information on the cookies used on our site. Privacy Policy