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  • Flow-Diversion For Complex Middle Cerebral Artery Aneurysms.

    Final Number:

    Mario Zanaty MD; Nohra Chalouhi MD; Stavropoula I. Tjoumakaris MD; Fernando Gonzalez; Robert H. Rosenwasser MD, FACS, FAHA; Pascal Jabbour MD

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2014 Annual Meeting

    Introduction: To evaluate the safety and efficacy of pipeline embolization device (PED) for treatment of large and complex middle cerebral artery (MCA) aneurysms

    Methods: We conducted a retrospective review of the clinical charts of all patients who underwent PED placement for aneurysm at our institution from October 2010 to October 2013. We included 10 patients of which 5 had large MCA aneurysms and 3 had giant ones. Fusiform unruptured aneurysms represented 7 of all 10 aneurysm. Angiographic and clinical follow-up were available for all patients mostly between 7 and 12 months.

    Results: We had no technical complications, no periprocedural morbidity and mortality. On follow-up we had no hemorrhagic complication, no aneurysm rupture and only one clinically significant thromboembolic event in a patient who discontinued antiplatelet therapy against medical advice. One patient had completely occluded his diseased vessel but remained asymptomatic. The overall complication rate was 30% (3/10). The complete occlusion rate was 77.77% (7/9).

    Conclusions: PED treatment for large, giant and bifurcation MCA aneurysms was successful, with favorable complete-occlusion rate, no mortality and a low morbidity rate.

    Patient Care: PED can be offered as an alternative treatment when surgery is contraindicated. This study makes place for a comparison between the two arms (surgery vs PED)

    Learning Objectives: PED treatment for MCA aneurysms has favorable outcomes with satisfying complete occlusion rates PED use in MCA was associated with a low complication rates. No patient expired in our study


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