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Marked decrease in coil and stent utilization following introduction of flow diversion technology.

Emanuela Crobeddu¹, Giuseppe Lanzino, David F Kallmes

¹Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota 55905, USA.

Journal of Neurointerventional Surgery

|May 1, 2012

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Flow diversion using the Pipeline Embolization Device (PED) significantly reduced coil and stent use for unruptured intracranial aneurysms. This disruptive technology changed treatment paradigms, decreasing adjunctive procedures and coil embolization needs.

Area of Science:

Neurosurgery
Interventional Neuroradiology
Vascular Neurology

Background:

Flow diversion is a novel treatment for unruptured intracranial aneurysms.
Its impact on traditional coiling and adjunctive techniques remains unclear.

Purpose of the Study:

To assess the effect of introducing flow diversion devices on coil and adjunctive technique utilization.
To evaluate changes in treatment strategies for unruptured intracranial aneurysms post-flow diverter introduction.

Main Methods:

Retrospective review of unruptured aneurysms treated at an institution.
Comparison of two groups: pre-Pipeline Embolization Device (PED) introduction (Group 1) and post-PED introduction (Group 2).

Main Results:

Keywords:

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The Pipeline Embolization Device (PED) was used in 21.7% of aneurysms in Group 2.
Stent-assisted procedures and parent artery sacrifice decreased significantly post-PED introduction (p=0.04 and p=0.046, respectively).
Mean coil utilization per aneurysm significantly decreased in Group 2 compared to Group 1 (p ≤ 0.0001).

Conclusions:

Flow diversion, specifically with the PED, is a disruptive technology in aneurysm treatment.
Introduction of the PED led to substantial reductions in coil and stent utilization for unruptured intracranial aneurysms.