Republished: Recurrence of a totally occluded aneurysm after treatment with a pipeline embolization device

J Neurointerv Surg. 2019 Sep;11(9):e5. doi: 10.1136/neurintsurg-2018-013842.rep. Epub 2018 May 24.

Abstract

Treatment with a pipeline embolization device (PED) is widely accepted as an excellent option for patients harboring giant, wide neck, saccular intracranial aneurysms. It has been shown to be safe and very effective. We describe a previously unreported case of a large middle cerebral artery aneurysm, related to the carotid tip, that was treated with a PED and coils. The 6 month follow-up angiogram demonstrated complete occlusion of the aneurysm. However, the 9 month angiogram revealed recurrent filling of the aneurysm sac. To our knowledge, this is the first report to describe recanalization of an aneurysm totally occluded on the control angiography after treatment with a PED. Unanswered questions include the mechanism of recanalization and the need for additional control angiograms and MRI following a previous examination revealing total aneurysm occlusion.

Keywords: aneurysm; complication; flow diverter.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Blood Vessel Prosthesis* / trends
  • Cerebral Angiography / methods
  • Embolization, Therapeutic / instrumentation*
  • Embolization, Therapeutic / trends
  • Endovascular Procedures / instrumentation
  • Endovascular Procedures / trends
  • Female
  • Humans
  • Intracranial Aneurysm / diagnostic imaging*
  • Intracranial Aneurysm / therapy*
  • Magnetic Resonance Imaging / trends
  • Recurrence
  • Treatment Outcome