The Pipeline Embolization Device (PED) was approved for the treatment of intracranial aneurysms from the petrous to the superior hypophyseal segment of the internal carotid artery. However, since its approval, its use for treatment of intracranial aneurysms in other locations and non-sidewall aneurysms has grown tremendously. The authors report on a cohort of 15 patients with 16 cerebral aneurysms that incorporated an end vessel with no significant distal collaterals, which were treated with the PED. The cohort includes 7 posterior communicating artery aneurysms, 5 ophthalmic artery aneurysms, 1 superior cerebellar artery aneurysm, 1 anterior inferior cerebellar artery aneurysm, and 2 middle cerebral artery aneurysms. None of the aneurysms achieved significant occlusion at the last follow-up evaluation (mean 24 months). Based on these observations, the authors do not recommend the use of flow diverters for the treatment of this subset of cerebral aneurysms.
Keywords: AICA = anterior inferior cerebellar artery; MCA = middle cerebral artery; OphA = ophthalmic artery; PCA = posterior cerebral artery; PCoA = posterior communicating artery; PED = Pipeline Embolization Device; PICA = posterior inferior cerebellar artery; PTA = percutaneous transluminal balloon angioplasty; Pipeline Embolization Device; SCA = superior cerebellar artery; aneurysm; failure; flow diversion; interventional neurosurgery; vascular disorders.