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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Neurosci. | doi: 10.3389/fnins.2019.01253

Endovascular treatment of large and giant vertebrobasilar aneurysms: Pipeline embolization device versus conventional stent

Jiejun Wang1, Luqiong Jia1, Zhibin Duan1, Zhongxiao Wang1,  Xinjian Yang1,  Yisen Zhang1* and  Ming Lv1*
  • 1Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, China

Abstract
Background: Endovascular treatment of large or giant vertebrobasilar aneurysms (VBAs) using conventional stents is challenging and has unsatisfactory outcomes.
Object: This study was performed to retrospectively analyze the efficacy and safety of a flow diverter in the treatment of large and giant VBAs.
Methods: We identified 78 patients with 83 large or giant VBAs who accepted endovascular treatment with a Pipeline embolization device (PED) or conventional stent from January 2014 to June 2018. The technical feasibility of the procedure, procedure-related complications, angiographic results, and clinical outcomes were evaluated.
Results: Forty-two patients (53.8%, 42/78) with 44 aneurysms (53.0%, 44/83) underwent endovascular treatment with PEDs. Thirty-six patients (46.2%, 36/78) with 39 aneurysms (47.0%, 39/83) underwent endovascular treatment with conventional stents. The complication rate in the PED group and conventional stent group was 7.1% (3/42) and 5.6% (2/36), respectively (odds ratio, 0.765; 95% confidence interval, 0.121–4.851; P = 0.776). During a median follow-up time of 28.8 months, the complete occlusion rate in the PED group and conventional stent group was 90.2% (37/41) and 70.3% (26/37), respectively (odds ratio, 3.913; 95% confidence interval, 1.122–13.652; P = 0.032).
Conclusions: Endovascular treatment with a PED is a promising and safe modality for large and giant VBAs, and the complication rate is acceptable, comparing with conventional endovascular treatment.

Keywords: endovascular treatment, pipeline, Large and giant aneurysm, Vertebrobasilar aneurysm, Conventional stenting

Received: 06 Aug 2019; Accepted: 05 Nov 2019.

Copyright: © 2019 Wang, Jia, Duan, Wang, Yang, Zhang and Lv. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Dr. Yisen Zhang, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, Beijing Municipality, China, zhang-yisen@163.com
Prof. Ming Lv, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, Beijing Municipality, China, dragontiger@163.com