Introduction: To assess the safety and efficacy of the pipeline embolization device in small aneurysms <10 mm one year after treatment.

Methods: Retrospective analysis was performed for pipeline embolization devices placed in 53 consecutive patients from May 2012 until August 2015 for treatment of aneurysms <10 mm. The treatment outcome was assessed by either digital subtraction angiography or MRI.

Results: There were 17 aneurysms measuring <4mm. 88% of these aneurysms were completely occluded after 1 yr (15/17) with a 5.9% complication rate (1/17). There were 24 aneurysms measuring 4-7 mm. 71% of these aneurysms were completely occluded after 1 year (17/24) with no complications. There were 12 aneurysms measuring 7-10mm. 83% of these aneurysms were completely occluded after 1 year (10/12) with an 8.3% complication rate (1/12).

Conclusions: The pipeline embolization device is safe and effective for treatment of small aneurysms <10 mm with a complication rate comparable to conventional endovascular techniques.

Patient Care: Demonstration of high efficacy and low complication rates one year after placement of the pipeline embolization device will allow patients with aneurysms ≤10 mm with another viable minimally invasive treatment option.

Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the safety and efficacy for using the pipeline embolization device for small aneurysms 2) Identify the pipeline embolization device as a viable alternative to conventional endovascular techniques for treatment of small aneurysms.

References: Griessenauer, Christoph J. MD; Ogilvy, Christopher S. MD; Foreman, Paul M. MD; Chua, Michelle H. BS; Harrigan, Mark R. MD; He, Lucy MD; Fusco, Matthew R. MD; Mocco, J.D. MD, MS; Stapleton, Christopher J. MD; Patel, Aman B. MD; Sonig, Ashish MD; Siddiqui, Adnan H. MD; Thomas, Ajith J. MD. Pipeline Embolization Device for Small Intracranial Aneurysms: Evaluation of Safety and Efficacy in a Multicenter Cohort.J Neurosurg. 2016 Mar 4:1-8. Nohra Chalouhi, MD, Mario Zanaty, MD, Alex Whiting, MD, Steven Yang, MS, Stavropoula Tjoumakaris, MS, David Hasan, MD, Robert M. Starke, MD, Shannon Hann, MD, Christine Hammer, MD, David Kung, MD, Robert Rosenwasser, MD, and Pascal Jabbour, MD. Safety and efficacy of the Pipeline Embolization Device in 100 small intracranial aneurysms. J Neurosurg. 2015 Jun;122(6):1498-502.