Browse > Article
http://dx.doi.org/10.3340/jkns.2016.59.5.521

Inadvertent Complication of a Pipeline Embolization Device for Treatment with Vertebral Artery Dissecting Aneurysm : Distal Tip Fracture of Delivery Wire  

Park, Jung Soo (Department of Neurosurgery, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital)
Kwak, Hyo Sung (Department of Radiology, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital)
Lee, Jong Myong (Department of Neurosurgery, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital)
Publication Information
Journal of Korean Neurosurgical Society / v.59, no.5, 2016 , pp. 521-524 More about this Journal
Abstract
Use of the Pipeline embolization device (PED) has increased based on studies about its safety and effectiveness, and new reports that describe perior postprocedural complications are now emerging. We report a rare periprocedural device-related complication that occurred during endovascular treatment with the pipeline embolization device for a dissecting aneurysm on the vertebral artery. A 55-year old woman was admitted due to left medullary infarction, and angiography showed a fusiform dilatation in the left vertebral artery that was suspicious for dissecting aneurysm. Endovascular treatment with PED was planned. Under general anesthesia, the procedure was performed without significant problems and a PED was deployed in an appropriate position. However, in the final step of the procedure, the distal tip of the PED delivery wire became engaged within a small branch of the posterior cerebral artery and fractured. Fortunately, imaging studies after the procedure revealed neither hemorrhagic nor ischemic stroke, and the patient recovered without neurological morbidities except initial symptoms.
Keywords
Pipeline embolization device; Aneurysm; Endovascular treatment;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Briganti F, Marseglia M, Leone G, Briganti G, Piccolo D, Napoli M, et al. : Endovascular treatment of a small aneurysm of the superior cerebellar artery with a flow-diverter device. A case report. Neuroradiol J 26 : 327-331, 2013   DOI
2 Chalouhi N, Tjoumakaris S, Dumont AS, Gonzalez LF, Randazzo C, Starke RM, et al. : Treatment of posterior circulation aneurysms with the pipeline embolization device. Neurosurgery 72 : 883-889, 2013   DOI
3 Chalouhi N, Tjoumakaris SI, Gonzalez LF, Hasan D, Pema PJ, Gould G : Spontaneous delayed migration/shortening of the pipeline embolization device : report of 5 cases. AJNR Am J Neuroradiol 34 : 2326-2330, 2013   DOI
4 Chalouhi N, Zanaty M, Whiting A, Tjoumakaris S, Hasan D, Ajiboye N, et al. : Treatment of ruptured intracranial aneurysms with the pipeline embolization device. Neurosurgery 76 : 165-172, 2015   DOI
5 Ding D, Liu KC : Microsurgical extraction of a malfunctioned pipeline embolization device following complete deployment. J Cerebrovasc Endovasc Neurosurg 15 : 241-245, 2013   DOI
6 Fiorella D, Lylyk P, Szikora I, Kelly ME, Albuquerque FC, McDougall CG : Curative cerebrovascular reconstruction with the Pipeline embolization device : the emergence of definitive endovascular therapy for intracranial aneurysms. J Neurointerv Surg 1 : 56-65, 2009   DOI
7 Fiorella D, Woo HH, Albuquerque FC, Nelson PK : Definitive reconstruction of circumferential, fusiform intracranial aneurysms with the pipeline embolization device. Neurosurgery 62 : 1115-1120, 2008   DOI
8 Hauck EF, Natarajan SK, Langer DJ, Hopkins LN, Siddiqui AH, Levy EI : Retrograde trans-posterior communicating artery snare-assisted rescue of lost access to a foreshortened pipeline embolization device : complication management. Neurosurgery 67 : 495-502, 2010   DOI
9 Kallmes DF, Hanel R, Lopes D, Boccardi E, Bonafe A, Cekirge S, et al. : International retrospective study of the pipeline embolization device : a multicenter aneurysm treatment study. AJNR Am J Neuroradiol 36 : 108-115, 2015   DOI
10 Jabbour P, Chalouhi N, Tjoumakaris S, Gonzalez LF, Dumont AS, Randazzo C, et al. : The Pipeline Embolization Device : learning curve and predictors of complications and aneurysm obliteration. Neurosurgery 73 : 113-120; discussion 120, 2013   DOI
11 Keskin F, Erdi F, Kaya B, Poyraz N, Keskin S, Kalkan E, et al. : Endovascular treatment of complex intracranial aneurysms by pipeline flow-diverter embolization device : a single-center experience. Neurol Res 37 : 359-365, 2015   DOI
12 Lylyk P, Miranda C, Ceratto R, Ferrario A, Scrivano E, Luna HR, et al. : Curative endovascular reconstruction of cerebral aneurysms with the pipeline embolization device : the Buenos Aires experience. Neurosurgery 64 : 632-642; discussion 642-643; quiz N6, 2009   DOI
13 Navarro R, Yoon J, Dixon T, Miller DA, Hanel RA, Tawk RG : Retrograde trans-anterior communicating artery rescue of unopened Pipeline Embolization Device with balloon dilation : complication management. J Neurointerv Surg 7 : e7, 2015   DOI
14 Nelson PK, Lylyk P, Szikora I, Wetzel SG, Wanke I, Fiorella D : The pipeline embolization device for the intracranial treatment of aneurysms trial. AJNR Am J Neuroradiol 32 : 34-40, 2011   DOI
15 Oh SY, Kim MJ, Kim BS, Shin YS : Treatment for giant fusiform aneurysm located in the cavernous segment of the internal carotid artery using the pipeline embolization device. J Korean Neurosurg Soc 55 : 32-35, 2014   DOI
16 Park MS, Albuquerque FC, Nanaszko M, Sanborn MR, Moon K, Abla AA, et al. : Critical assessment of complications associated with use of the Pipeline Embolization Device. J Neurointerv Surg 7 : 652-659, 2015   DOI
17 Yu SC, Kwok CK, Cheng PW, Chan KY, Lau SS, Lui WM, et al. : Intracranial aneurysms : midterm outcome of pipeline embolization device--a prospective study in 143 patients with 178 aneurysms. Radiology 265 : 893-901, 2012   DOI
18 Albuquerque FC, Park MS, Abla AA, Crowley RW, Ducruet AF, Mc-Dougall CG : A reappraisal of the Pipeline embolization device for the treatment of posterior circulation aneurysms. J Neurointerv Surg 7 : 641-645, 2015   DOI
19 Becske T, Kallmes DF, Saatci I, McDougall CG, Szikora I, Lanzino G, et al. : Pipeline for uncoilable or failed aneurysms : results from a multicenter clinical trial. Radiology 267 : 858-868, 2013   DOI
20 Szikora I, Berentei Z, Kulcsar Z, Marosfoi M, Vajda ZS, Lee W, et al. : Treatment of intracranial aneurysms by functional reconstruction of the parent artery : the Budapest experience with the pipeline embolization device. AJNR Am J Neuroradiol 31 : 1139-1147, 2010   DOI
21 Munich SA, Tan LA, Keigher KM, Chen M, Moftakhar R, Lopes DK : The Pipeline Embolization Device for the treatment of posterior circulation fusiform aneurysms : lessons learned at a single institution. J Neurosurg 121 : 1077-1084, 2014   DOI