Second-stage pipeline embolization device treatment with coil embolization for large cerebral aneurysm prevents silent diffusion-weighted image ischemic infarction: a retrospective study

Background Second-stage flow diversion with coil embolization may improve occlusion outcomes and reduce periprocedural complications in patients with cerebral aneurysm. However, the actual cause behind this is unclear. In this study, we aimed to compare the efficacy and safety of second-stage pipeli...

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Bibliographic Details
Published in:Egyptian journal of radiology and nuclear medicine 2024-12, Vol.55 (1), p.25-7
Main Authors: Kawamura, Yosuke, Takigawa, Tomoji, Nariai, Yasuhiko, Hyodo, Akio, Suzuki, Kensuke
Format: Article
Language:English
Subjects:
Aneurysms
Aspirin
Body image
Care and treatment
Carotid arteries
Clopidogrel
Coiling
Demographics
Drunk driving
Embolization
Flow diversion
Hemodynamics
Intracranial aneurysms
Ischemia
Magnetic resonance imaging
Patients
Stenting
Ticagrelor
Variables
Veins & arteries
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Summary:Background Second-stage flow diversion with coil embolization may improve occlusion outcomes and reduce periprocedural complications in patients with cerebral aneurysm. However, the actual cause behind this is unclear. In this study, we aimed to compare the efficacy and safety of second-stage pipeline embolization device (PED) and single-stage PED with coil embolization. Results Of the 22 treated patients with aneurysm, 10 and 12 were treated with second-stage PED and single-stage PED with coil embolization, respectively. The mean follow-up duration was 29.6 months. The mean numbers of diffusion-weighted image (DWI)-positive spots on day 1 post-procedure were 4.9 and 10.8 in the second-stage and single-stage PED with coil embolization groups, respectively (P = 0.01). Deterioration of the modified Rankin scale score was not [greater than or equal to] 2 in any patient during follow-up in the second-stage PED group but was observed in 16.7% of cases (2/12) in the single-stage PED with coil embolization group (P = 0.48). On follow-up angiography, complete occlusion was observed in all patients (10/10) in the second-stage PED group and 66.7% (8/12) in the single-stage PED with coil embolization group (P = 0.09). Conclusions The second-stage PED strategy significantly reduces the number of DWI high-intensity spots, leading to the prevention of ischemic complications. This strategy may help to prevent complications and reduce morbidity.
ISSN:0378-603X
2090-4762
DOI:10.1186/s43055-024-01199-x