Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA.
Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, USA.
Interv Neuroradiol. 2023 Dec;29(6):710-714. doi: 10.1177/15910199221111284. Epub 2022 Jun 26.
Flow diversion of intracranial aneurysms with the Pipeline Embolization Device (PED) is frequently performed, but the outcomes of retreatment for aneurysms that failed to occlude after prior treatment with PED have not been well studied. Here, we report the safety and efficacy of PED retreatment after initial failure to occlude.
Clinical and angiographic data from eligible patients were retrospectively assessed for demographics, aneurysm occlusion status, and clinical outcomes. Patients were included in this study if they underwent PED retreatment to treat an aneurysm that had previously been treated with PED.
Retreatment of previously flow-diverted aneurysms with PED was performed in 42 cases. At final angiographic follow-up, angiographic improvement was observed after 45% (19/42) of retreatments and complete aneurysm occlusion was observed following 26% (11/42). Significant clinical complications occurred in 10% (4/42) of PED retreatments.
Retreatment of intracranial aneurysms with PED following initial failure to achieve aneurysm occlusion has a low rate of subsequent complete aneurysm occlusion.
颅内动脉瘤的血流导向装置（PED）栓塞术经常被应用，但对于首次 PED 治疗后未闭塞的动脉瘤进行再次治疗的结果尚未得到很好的研究。在此，我们报告了 PED 初始治疗失败后再次治疗的安全性和有效性。
对符合条件的患者的临床和血管造影数据进行回顾性评估，以了解人口统计学、动脉瘤闭塞情况和临床结果。如果患者先前接受过 PED 治疗的动脉瘤再次接受 PED 治疗，则将其纳入本研究。
对先前经 PED 血流导向治疗的动脉瘤进行了 42 例再治疗。在最终的血管造影随访中，45%（19/42）的再治疗后出现了血管造影改善，26%（11/42）的动脉瘤完全闭塞。10%（4/42）的 PED 再治疗出现了明显的临床并发症。
对于首次 PED 治疗未能完全闭塞的颅内动脉瘤进行再次治疗，其随后完全闭塞的发生率较低。
