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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Area of Science:

  • Endovascular Neurosurgery
  • Cerebrovascular Diseases
  • Medical Devices

Background:

  • Pipeline embolization devices (PEDs) are increasingly utilized for treating posterior circulation aneurysms.
  • Vertebral artery intracranial aneurysms (VAIAs) present unique challenges in endovascular treatment.

Purpose of the Study:

  • To evaluate the safety and efficacy of PEDs in managing small to medium (≤12 mm) unruptured VAIAs.
  • To identify predictors of aneurysm occlusion and complications following PED treatment.

Main Methods:

  • Analysis of data from 76 patients with 78 unruptured VAIAs treated with PEDs across 14 centers (PLUS study, 2014-2019).
  • Univariate analyses were conducted to determine factors influencing occlusion and complication rates.
  • Successful PED placement was achieved in all cases, with a median follow-up of 7 months.

Main Results:

  • Complete aneurysm occlusion was achieved in 89.6% of cases, meeting the primary efficacy endpoint in 86.6%.
  • The combined major morbidity and mortality rate was 2.6%, with 98.7% of patients experiencing a good prognosis.
  • Ischemic stroke occurred in 10.5% of patients; adjuvant coiling and successful post-procedural adjustment were identified as predictors.

Conclusions:

  • PEDs demonstrate a high success rate, excellent occlusion, and low morbidity/mortality for treating unruptured VAIAs ≤12 mm.
  • PEDs represent a promising endovascular therapeutic option for this patient cohort.