Open AccessEndovascular Reconstruction of Intracranial Aneurysms with the Pipeline Embolization Device in Pediatric Patients: A Single-Center Series
Author(s) -
Peyman Shirani,
Saeedeh Mirbagheri,
Maksim Shapiro,
Eytan Raz,
Ashkan Mowla,
Bita Semsarieh,
Howard A. Riina,
Peter Kim Nelson
Publication year - 2019
Publication title -
interventional neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.07
H-Index - 5
eISSN - 1664-9737
pISSN - 1664-5545
DOI - 10.1159/000496291
Subject(s) - medicine , embolization , aneurysm , radiology , surgery , etiology , occlusion , angiography , cerebral angiography , internal carotid artery
Background: Pediatric intracranial aneurysms tend to differ in etiology, size, and location from their adult counterparts, and they are often less amenable to microsurgical clip reconstruction techniques. Endovascular treatment with detachable coils is an accepted treatment technique for pediatric patients, though high recurrence rates have been reported with coil embolization of large and giant aneurysms in this population. While the Pipeline Embolization Device (PED) is FDA-approved for adult intracranial aneurysms, the use of PEDs in pediatric patients is considered off-label. Case Descriptions: We present 3 cases of pediatric intracranial aneurysms in a 5-year-old male, a 12-year-old male, and a 12-year-old female who presented with symptoms including seizure, headache, and blurred vision. The 2 male patients were found to have intradural vertebral artery saccular aneurysms, while the female patient had a paraophthalmic right internal carotid complex aneurysm. After endovascular reconstruction of the aneurysms with PEDs, follow-up angiography showed complete occlusion of the previous aneurysms with no residual aneurysm filling in all 3 cases. Conclusion: While further investigation is needed, the evidence presented here supports the conclusion that the PED can be an effective and viable treatment strategy in the pediatric population.