J Cerebrovasc Endovasc Neurosurg.  2014 Jun;16(2):112-118. 10.7461/jcen.2014.16.2.112.

Pipeline Embolization Device for Giant Internal Carotid Artery Aneurysms: 9-Month Follow-Up Results of Two Cases

• Jeon HJ
• Kim DJ
• Kim BM
• Lee JW

• KMID: 1963179
• DOI: http://doi.org/10.7461/jcen.2014.16.2.112

Abstract

The pipeline(TM) embolization device (PED) is a braided, tubular, bimetallic endoluminal implant used for occlusion of intracranial aneurysms through flow disruption along the aneurysm neck. The authors report on two cases of giant internal carotid artery aneurysm treated with the PED. In the first case, an aneurysm measuring 26.4 mm was observed at the C3-C4 portion of the left internal carotid artery in a 64-year-old woman who underwent magnetic resonance imaging (MRI) for dizziness and diplopia. In the second case, MRI showed an aneurysm measuring 25 mm at the C4-C5 portion of the right internal carotid artery in a 39-year-old woman with right ptosis and diplopia. Each giant aneurysm was treated with deployment of a PED (3.75 mm diameter/20 mm length and 4.5 mm diameter/25 mm length, respectively). Nine months later, both cases showed complete radiological occlusion of the giant intracranial aneurysm and sac shrinkage. We suggest that use of the PED can be a therapeutic option for giant intracranial aneurysms.

Keyword

Flow diverter; Pipeline embolization device; Embolization; Giant intracranial aneurysm

MeSH Terms

Adult
Aneurysm*
Carotid Artery, Internal*
Diplopia
Dizziness
Female
Follow-Up Studies*
Humans
Intracranial Aneurysm
Magnetic Resonance Imaging
Middle Aged
Neck

Figure

• 

  Fig. 1 A giant aneurysm located at the C3-C4 portion of the left internal carotid artery. Initial T2-weighted MRI (A), cerebral angiography (B), SPECT (C), after deployment of PED (D and E), CTA three months later (F), angiography six months later (G and H), CTA nine months later showing sac shrinkage (I). MRI = magnetic resonance imaging; SPECT = single photon emission computed tomography; PED = pipeline embolization device; CTA = computerized tomography angiography

• 

  Fig. 2 A giant aneurysm located at the C4-C5 portion of the right internal carotid artery. Initial T2-weighted MRI (A), follow-up CTA (B), cerebral angiography (C), after deployment of PED (D and E), CTA three months later with small filling portion (F), angiography six months later (G) and (H), CTA nine months later without remnant sac (I).MRI = magnetic resonance imaging; PED = pipeline embolization device; CTA = computerized tomography angiography

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