{"title":"Pipeline embolization device in treating middle cerebral artery aneurysms: a single-center experience in 69 consecutive patients.","authors":"Haoyu Zhu, Jiarui Zhang, Lian Liu, Chao Ma, Yuzhou Chang, Yuqi Song, Xiguang Fu, Longhui Zhang, Yupeng Zhang, Chuhan Jiang, Shikai Liang","doi":"10.1007/s00234-025-03606-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The pipeline embolization device (PED) has been established as an effective treatment option for aneurysms within its designated indications. Recently, its off-label applications, including treating middle cerebral artery (MCA) aneurysms, have increased. This study augmented the current literature by examining the outcomes of PED utilization for MCA aneurysms.</p><p><strong>Methods: </strong>We collected data from consecutive patients with MCA aneurysms treated with PED between June 2016 and December 2021. Particularly, we collected data on patient demographics, aneurysm characteristics, procedural details, perioperative complications, and clinical and angiographic follow-up results.</p><p><strong>Results: </strong>A total of 69 patients (mean age 47.4 years; 42.0% female) with MCA aneurysms who underwent PED treatment were included in this study. Among these, 5 aneurysms had ruptured previously, and 10 patients had previously undergone open surgery or received endovascular treatment. In the last angiographic follow-up, conducted at a mean of 19.0 ± 13.5 months, 44 of 56 (78.6%) aneurysms achieved complete occlusion. Ten (17.9%) and three (5.4%) patients exhibited in-stent stenosis and MCA occlusion, respectively. During a mean clinical follow-up period of 35.1 months, 10 of 63 patients (15.8%) experienced major procedure-related complications, including 2 hemorrhagic (3.2%) and 8 ischemic (12.7%) events.</p><p><strong>Conclusion: </strong>PED is a viable treatment for MCA aneurysms, particularly those with fusiform and wide-necked characteristics that pose challenges for traditional open surgery. PED shows favorable clinical outcomes and occlusion rates and presents a notable risk of complications and in-stent restenosis. Therefore, careful patient selection is crucial when using PEDs to treat MCA aneurysms.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuroradiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00234-025-03606-0","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: The pipeline embolization device (PED) has been established as an effective treatment option for aneurysms within its designated indications. Recently, its off-label applications, including treating middle cerebral artery (MCA) aneurysms, have increased. This study augmented the current literature by examining the outcomes of PED utilization for MCA aneurysms.
Methods: We collected data from consecutive patients with MCA aneurysms treated with PED between June 2016 and December 2021. Particularly, we collected data on patient demographics, aneurysm characteristics, procedural details, perioperative complications, and clinical and angiographic follow-up results.
Results: A total of 69 patients (mean age 47.4 years; 42.0% female) with MCA aneurysms who underwent PED treatment were included in this study. Among these, 5 aneurysms had ruptured previously, and 10 patients had previously undergone open surgery or received endovascular treatment. In the last angiographic follow-up, conducted at a mean of 19.0 ± 13.5 months, 44 of 56 (78.6%) aneurysms achieved complete occlusion. Ten (17.9%) and three (5.4%) patients exhibited in-stent stenosis and MCA occlusion, respectively. During a mean clinical follow-up period of 35.1 months, 10 of 63 patients (15.8%) experienced major procedure-related complications, including 2 hemorrhagic (3.2%) and 8 ischemic (12.7%) events.
Conclusion: PED is a viable treatment for MCA aneurysms, particularly those with fusiform and wide-necked characteristics that pose challenges for traditional open surgery. PED shows favorable clinical outcomes and occlusion rates and presents a notable risk of complications and in-stent restenosis. Therefore, careful patient selection is crucial when using PEDs to treat MCA aneurysms.
期刊介绍：
Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.
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