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Flex vs. Vantage Pipeline™ Flow Diverters: Technical analysis in treating complex fusiform basilar artery aneurysm
Harsh Desai1, Sonam Thind1, Rami Z Morsi1
1Department of Neurology, University of Chicago, Chicago, IL, USA.
Summary
The Pipeline™ Vantage Flow Diverter offers a simpler deployment than the Flex model for basilar artery aneurysms. This new device may lead to better occlusion rates and shorter anti-platelet therapy.
Area of Science:
- Endovascular neurosurgery
- Cerebrovascular disease
- Medical device technology
Background:
- Large fusiform basilar artery aneurysms are challenging to treat.
- Flow diverters are an endovascular option for complex aneurysms.
- Comparing deployment techniques of different flow diverters is crucial for clinical practice.
Purpose of the Study:
- To demonstrate the deployment of the Pipeline™ Vantage Flow Diverter in a patient with a large symptomatic fusiform basilar artery aneurysm.
- To compare the deployment ease and technique of the Vantage device with the Pipeline™ Flex model.
- To highlight potential advantages of the Vantage device, such as streamlined deployment and possible improved outcomes.
Main Methods:
- Case presentation of an adult patient with a large symptomatic fusiform basilar artery aneurysm.
- In-situ comparison of Pipeline™ Vantage and Pipeline™ Flex flow diverter deployment in the same basilar artery.
- Video documentation of the deployment procedures, emphasizing differences in technique and handling.
- Use of a LOBO® device occluder in conjunction with Vantage stents.
Main Results:
- The Pipeline™ Vantage Flow Diverter demonstrated a simpler and more streamlined deployment process compared to the Flex model.
- Vantage deployment primarily involved unsheathing, unlike the Flex which required more complex maneuvering.
- The procedure involved deploying two Vantage stents and a LOBO® device occluder before the Flex device was fully deployed.
- Potential for higher aneurysmal occlusion rates and shorter anti-platelet regimens with the Vantage device was suggested.
Conclusions:
- The Pipeline™ Vantage Flow Diverter presents a potentially simpler and more efficient deployment method for complex basilar artery aneurysms compared to the Flex model.
- The Vantage device's design may offer advantages in terms of procedural efficiency and potentially clinical outcomes, including reduced anti-platelet therapy duration.
- Further investigation into the efficacy and safety of the Vantage device, and consideration of alternatives like Pipeline™ Shield, are warranted.
