Authors' objectives:

To assess the evidence available on the efficacy, safety and coverage related aspects regarding Pipeline embolization device (PED) in patients with UIA.

Authors' recommendations: In patients with broad neck IA (specially unruptured), the PED could be used as a therapeutic alternative for aneurismal reconstruction. The complete occlusion observed by angiography in the case series mentioned is greater than 90% at one year follow-up. This is higher than the occlusion rates reported in the post-treatment follow-up using conventional endovascular treatment with coils. The rate of complications is higher than 6% and there are fatal cases. As limiting factor for PED indication in UIA, it is worth mentioning that the population who participated in these case series is small (overall 102 patients) and heterogeneous. It involved patients with giant UIA and mass effect as well as ruptured IA; therefore not all the data can be extrapolated to UIA. Another important limitation is that these patients have not been followed-up for long periods (>6-12 months); its safety for bifurcation aneurysms has not been determined, and since the patients should have received double antiaggregation, subarachnoid hemorrhage is a relative contraindication.In the patients with broad neck UIA technically-difficult to resolve through endovascular means, the PED seems to be a promising alternative treatment.

Project Status: Completed

URL for project: http://www.iecs.org.ar/iecs-visor-publicacion.php?cod_publicacion=1246&origen_publicacion=publicaciones

Year Published: 2011

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Argentina

Organisation Name: Institute for Clinical Effectiveness and Health Policy

Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA

Contact Name: info@iecs.org.ar

Contact Email: info@iecs.org.ar

Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)