Pipeline embolization device for aneurysm recurrence after stent-assisted coiling

Since the emergence of the Pipeline Embolization Device (PED), its off-label use has significantly improved the treatment effectiveness of complex intracranial aneurysms, including the treatment of recurrent aneurysms. Although PED is effective in this situation, there is still a lack of evidence-based medicine for its role in recurrent aneurysms after stent-assisted coiling. The aim of this study is to evaluate the safety and efficacy of PED treatment for recurrent aneurysms after stent-assisted coiling.

This study included 10 patients who underwent stent-assisted coiling but subsequently received PED treatment again due to aneurysm recurrence or rebleeding. The mean time between initial treatment and subsequent treatment is 12 months. Clinical outcomes include complications and modified Rankin Scale (mRS) scores, as well as evidence of complete occlusion.

All PEDs were successfully placed, with one case of minor perioperative complications. During the 6-month follow-up after PED implantation, 10 cases of recurrent aneurysms were completely occluded without any adverse clinical sequelae. In one case of vertebral artery aneurysm, balloon dilation was performed before placing PED due to arterial stenosis proximal to the aneurysm.

The use of PED to treat recurrent aneurysms after stent-assisted coiling is a safe and effective treatment method.