Pipeline embolization device for intracranial aneurysm: a systematic review

Area of Science:

• Endovascular neurosurgery
• Cerebrovascular disease management
• Medical device technology

Background:

• The Pipeline Embolization Device (PED) is an innovative endovascular stent for complex intracranial aneurysms (IAs).
• Its application spans ruptured and unruptured IAs across anterior and posterior circulations.

Purpose of the Study:

• To systematically review the clinical efficacy and safety of the PED for intracranial aneurysm treatment.
• To evaluate outcomes in a large patient cohort with diverse IA types and locations.

Main Methods:

• Systematic review of ten eligible clinical reports.
• Analysis of 448 intracranial aneurysms in 414 patients.
• Assessment of deployment success, aneurysm obliteration, and complication rates.

Main Results:

• Successful PED deployment in approximately 95% of procedures.
• Aneurysm obliteration achieved in 82.9% of IAs at 6 months.
• Periprocedural complication and mortality rates were 6.3% and 1.5%, respectively.

Conclusions:

• The PED demonstrates safety and efficacy for unruptured intracranial aneurysms.
• Caution is recommended for PED use in acute subarachnoid hemorrhage.
• Limitations include the need for antiplatelet therapy and risks of rupture and hemorrhage.