Introduction: Flow diversion using the Pipeline embolization device has become a popular tool in the management of cerebral aneurysms. The Pipeline Flex device (PFD) is a newer generation device with a modified delivery system. The aim of this study is to present our initial experience with this device.

Methods: 20 consecutive patients with aneurysms treated using the PFD between March 2015 and August 2015 were identified. Electronic medical records were reviewed to collect data regarding patient and aneurysm characteristics, to identify technical difficulties and complications associated with the procedure and to evaluate early angiographic outcomes.

Results: The mean patient age was 56 years. The mean aneurysm size was 7 mm. 19 aneurysms were saccular (95%) and 1 was fusiform in shape.19 aneurysms were in the anterior circulation (95%). There were 6 previously treated aneurysms and 14 aneurysms treated with the PFD as a first line treatment. Only one device was used in all cases. The PFD was successfully deployed in 18 cases (90%) versus no successful deployment in 2 cases (10%) due to vessel tortuosity. In patients with successful deployment, post-procedural angiographic evaluation showed successful aneurysm occlusion with persistent contrast stasis into the late venous phase in 17/18 patients (94.4%). The incompletely occluded aneurysm was an 11 mm fusiform dysplastic internal carotid artery aneurysm. Complications occurred in 1 case (5%) where the device did not fully open leading to partial thrombosis of the carotid artery.

Conclusions: The PFD represents a safe and effective new treatment tool with a high technical success rate for managing cerebral aneurysms.

Patient Care: This study is one of the first to present data regarding the Pipeline Flex Device. It presents valuable information regarding a new device for aneurysm management.

Learning Objectives: "By the conclusion of this session, participants should be able to: 1) Describe the importance of flow diversion, particularly the Pipeline Flex device in aneurysm management 2) Discuss, in small groups the safety and efficacy of the Pipeline Flex Device and the changes made as compared to the older generation device.

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