Sage Journals: Discover world-class research

Abstract

Background

Flow diversion with the Pipeline embolization device (PED) is a widely accepted treatment modality for aneurysm occlusion. Previous reports have shown no recanalization of aneurysms on long-term follow-up once total occlusion has been achieved.

Case description

We report on a 63-year-old male who had a large internal carotid artery cavernous segment aneurysm. Treatment with PED resulted in complete occlusion of the aneurysm. However, follow-up angiography at four years revealed recurrence of the aneurysm due to disconnection of the two PEDs placed in telescoping fashion.

Conclusion

Herein, we present the clinico-radiological features and discuss the possible mechanisms resulting in the recanalization of aneurysms treated with flow diversion.

Keywords

Aneurysm flow diverter Pipeline Embolization Device recurrence

Get full access to this article

View all access options for this article.

References

Lylyk

Miranda

Ceratto

et al.

Curative endovascular reconstruction of cerebral aneurysms with the Pipeline embolization device: The Buenos Aires experience. Neurosurgery 2009; 64: 632–642.

Becske

Brinjikji

Potts

et al.

Long-term clinical and angiographic outcomes following Pipeline embolization device treatment of complex internal carotid artery aneurysms: Five-year results of the Pipeline for Uncoilable or Failed Aneurysms trial. Neurosurgery 2017; 80: 40–48.

Nelson

Lylyk

Szikora

et al.

The Pipeline embolization device for the intracranial treatment of aneurysms trial. AJNR Am J Neuroradiol 2011; 32: 34–40.

Daou

Atallah

Chalouhi

et al.

Aneurysms with persistent filling after failed treatment with the Pipeline embolization device. J Neurosurg. Epub ahead of print 4 May 2018. DOI: 10.3171/2017.12.JNS163090.

Trivelato

Ulhôa

Rezende

et al.

Recurrence of a totally occluded aneurysm after treatment with a Pipeline embolization device. J Neurointerv Surg. Epub ahead of print 24 May 2018. DOI: 10.1136/neurintsurg-2018-013842.rep.

Lang

Assis

Wong

et al.

Rapid delayed growth of ruptured supraclinoid blister aneurysm after successful flow diverting stent treatment. J Neurointerv Surg 2017; 9: e16.

Iihara

Murao

Sakai

et al.

Continued growth of and increased symptoms from a thrombosed giant aneurysm of the vertebral artery after complete endovascular occlusion and trapping: The role of vasa vasorum. Case report. J Neurosurg 2003; 98: 407–413.

Dehdashti

Thines

Willinsky

et al.

Symptomatic enlargement of an occluded giant carotid-ophthalmic aneurysm after endovascular treatment: The vasa vasorum theory. Acta Neurochir 2009; 151: 1153–1158.

Nagahiro

Takada

Goto

et al.

Thrombosed growing giant aneurysms of the vertebral artery: Growth mechanism and management. J Neurosurg 1995; 82: 796–801.

10.

Schubiger

Valavanis

Wichmann

. Growth-mechanism of giant intracranial aneurysms; demonstration by CT and MR imaging. Neuroradiology 1987; 29: 266–271.

11.

McTaggart

Santarelli

Marcellus

et al.

Delayed retraction of the Pipeline embolization device and corking failure: Pitfalls of Pipeline embolization device placement in the setting of a ruptured aneurysm. Neurosurgery 2013; 72(Suppl 2 Operative): onsE245–onsE250. discussion onsE250–onsE251.

12.

Heit

Telischak

et al.

Pipeline embolization device retraction and foreshortening after internal carotid artery blister aneurysm treatment. Interv Neuroradiol 2017; 23: 614–619.

Very delayed discontinuation of telescoped Pipeline embolization devices: a case report

Abstract

Background

Case description

Conclusion

Keywords

Get full access to this article

References