The Pipeline Embolization Device: learning curve and predictors of complications and aneurysm obliteration.

摘要: BACKGROUND The Pipeline Embolization Device (PED) has emerged as a promising treatment for intracranial aneurysms. OBJECTIVE To assess the safety and efficacy of PED, to analyze effect operator experience on complication rate, identify predictors complications obliteration. METHODS A total 109 patients with 120 aneurysms were treated PED at our institution. patient population was divided into 3 consecutive equal groups whether overall major rates decreased over time: group 1, 1 through 37; 2, 38 73; 3, 74 109. RESULTS number PEDs used 1.40 per aneurysm. Symptomatic procedure-related occurred in 11% 3.7% patients, respectively. rate from 16.2% 5.6% fell dramatically 10.8% 0% 2 (P < .05). Procedure time significantly = .04). In multivariate analysis, previously predictive procedural .02). At latest follow-up, 65.8% completely occluded, 9.6% nearly 24.6% incompletely occluded. fusiform .05) shorter angiographic follow-up .03) negative aneurysm CONCLUSION therapy may have an acceptable safety-efficacy profile. risk appears decrease physician experience, supporting existence learning curve. Patients higher rates, whereas achieve lower obliteration rates.