Safety and Effectiveness of the Pipeline Flex Embolization Device With Shield Technology for the Treatment of Intracranial Aneurysms: Midterm Results From a Multicenter Study. Issue 1 (10th September 2019)

• Record Type: Journal Article
• Authors: Trivelato, Felipe Padovani; Wajnberg, Eduardo; Rezende, Marco Túlio Salles; Ulhôa, Alexandre Cordeiro; Piske, Ronie Leo; Abud, Thiago Giansante; de Castro-Afonso, Luís Henrique; Abath, Carlos Gustavo Coutinho; Nakiri, Guilherme Seizem; Araújo, João Francisco Santoro; Silva, José Laércio Júnior; Tosello, Renato Tavares; Vanzin, José Ricardo; Manzato, Luciano Bambini; Baccin, Carlos Eduardo; da Mota, Bruno Anderson Araújo; Abud, Daniel Giansante
• Is Part Of: Neurosurgery. Volume 87:Issue 1(2020)
• Page Start: 104
• Page End: 111
• Publication Date: 2019-09-10
• Subjects: Aneurysm -- Embolization -- Endovascular -- Flow diverter; Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyz356
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: BACKGROUND: The safety and efficacy of the first generation of the Pipeline Embolization Device (PED; Medtronic Inc) have been proven in large case series. Ischemic events are one of the most common complications following treatment of aneurysms with flow diverters. The new PED Flex with Shield technology (PED Shield; Medtronic Inc) was introduced to minimize the rate of complications. OBJECTIVE: To evaluate the outcomes of patients harboring aneurysms treated with the PED Shield. METHODS: This was an observational, prospective, single-arm multicenter study of patients treated with the PED Shield. The primary safety endpoint was the absence of major neurological complications and death. The secondary effectiveness endpoint was angiographic occlusion at 6 and 12 mo. Technical complications were also reported. RESULTS: Between November 2017 and December 2018, 151 patients from 7 centers with 182 aneurysms were enrolled. The mean aneurysm size was 7.0 mm; 27 (14.8%) aneurysms were large, and 7 (3.8%) were giant. In 141 of 151 patients (93.4%), the primary endpoint was reached. The overall rate of periprocedural complications was 7.3%. Of the aneurysms, 79.7% met the study's secondary endpoint of complete occlusion at 6 mo and 85.3% at 12 mo. CONCLUSION: The PED Shield is a safe and effective treatment for intracranial aneurysms. The results regarding total occlusion and ischemic complications did not differ from those obtained in case series using previous versions of the PED. Long-term follow-up and comparative studies are required to provide stronger conclusions regarding the reduced thrombogenicity of this device.