Ruptured Intracranial Aneurysms Treated with the Pipeline Embolization Device: A Systematic Review and Pooled...

Area of Science:

• Neuroendovascular surgery
• Cerebrovascular disease management
• Medical device technology

Background:

• The Pipeline Embolization Device (PED) is a flow-diverting stent used for intracranial aneurysms.
• It is applied off-label for specific ruptured aneurysms unsuitable for traditional treatments.

Purpose of the Study:

• To assess the safety and efficacy of the PED in treating ruptured intracranial aneurysms.

Main Methods:

• A systematic review of MEDLINE, EMBASE, and Scopus databases (Jan 2011-Mar 2020).
• Analysis included 12 studies with 145 patients and 145 aneurysms.
• Nonparametric tests and logistic regression were used for data analysis.

Main Results:

• Mean aneurysm size was 5.9 mm; most were blister (51.0%) or dissecting (26.9%) aneurysms.
• A 2.1% rerupture rate was observed, with larger aneurysm size predicting rerupture (P = .008).
• Complete aneurysm occlusion was achieved in 87.5% of cases with radiographic follow-up; 16.5% experienced symptomatic neurologic complications.

Conclusions:

• The PED is effective for treating ruptured blister and dissecting intracranial aneurysms.
• The treatment demonstrated a 2.1% rerupture rate and an 87.5% complete occlusion rate.
• Larger aneurysm size is a significant predictor of rerupture.