Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Neurosurgery. 2012 Sep;71(3):679-91; discussion 691. doi: 10.1227/NEU.0b013e318260fe86.
Endovascular coil embolization is an established method of treatment for intracranial aneurysms. The pipeline embolization device (PED) is a low-porosity endovascular stent designed to reconstruct the parent artery and decrease blood flow into the aneurysm.
To report a series of 36 patients treated with the PED.
Thirty-six patients underwent PED placement for aneurysm at the Jefferson Hospital for Neuroscience from October 2010 to November 2011. Clinical charts were reviewed.
Thirty-six patients with 42 aneurysms were treated (3 male; 33 female; ages, 34-82; mean age, 60.1 years). Forty-one aneurysms were located in the anterior circulation, whereas one was located at the vertebrobasilar junction. PED placement was successful in all patients and resulted in stasis within all treated aneurysms. Symptomatic postoperative complications were witnessed in 13.9% (n = 5) of patients. These complications included intracerebral hemorrhage (n = 4), dissection (n = 1), symptomatic stroke (n = 2), and death (n = 1).
Treatment of simple or complex intracranial aneurysms with PEDs alone or in conjunction with coil embolization is technically feasible, and the deployment technique requires a high degree of endovascular skills. Major perioperative adverse events must be studied. Respect for the indications of the procedure is crucial to justify the risk.
血管内线圈栓塞术是治疗颅内动脉瘤的一种成熟方法。Pipeline 栓塞装置（PED）是一种低孔隙率的血管内支架，旨在重建母动脉并减少血流进入动脉瘤。
报告一组 36 例接受 PED 治疗的患者。
2010 年 10 月至 2011 年 11 月，Jefferson 神经科学医院对 36 例动脉瘤患者行 PED 放置术。回顾临床病历。
36 例患者（3 例男性；33 例女性；年龄 34-82 岁；平均年龄 60.1 岁）共 42 个动脉瘤。41 个动脉瘤位于前循环，1 个位于椎基底动脉交界处。所有患者均成功放置 PED，所有治疗的动脉瘤内均出现停滞。术后有 13.9%（n=5）的患者出现症状性并发症。这些并发症包括脑出血（n=4）、夹层（n=1）、症状性卒中（n=2）和死亡（n=1）。
单独或联合线圈栓塞术用 PED 治疗简单或复杂的颅内动脉瘤在技术上是可行的，并且部署技术需要高度的血管内技能。必须研究主要围手术期不良事件。尊重该手术的适应证对于证明风险是至关重要的。
