ArticleAJNR. American journal of neuroradiology2015
Risk Factors for Hemorrhagic Complications following Pipeline Embolization Device Treatment of Intracranial Aneurysms: Results from the International Retrospective Study of the Pipeline Embolization Device.
Article in AJNR. American journal of neuroradiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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Who cites it
30 citing papers in PubMed, 79 citations in OpenAlex.
- Comparative Safety and Efficacy of Dual Antiplatelet Therapy Regimens in Flow Diversion for Intracranial Aneurysms: a Systematic Review and Network Meta-Analysis.Clinical neuroradiology · 2026Review
- Clinical Outcomes and Device-Related Complications Following Flow Diverter Stent Treatment of Unruptured Intracranial Aneurysms: A Single-Center Retrospective Study.Diagnostics (Basel, Switzerland) · 2026Article
- Comaneci stent-angioplasty for the optimization of inadequately deployed flow diverter stents.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026Article
- Late-stage microsurgical intrasaccular thrombectomy for visual decline after flow diversion of a large ophthalmic internal carotid artery aneurysm: a hybrid management strategy. Illustrative case.Journal of neurosurgery. Case lessons · 2026Article
- Longitudinal volume evolution of large and giant intracranial aneurysms following endovascular flow diversion.Brain & spine · 2026Article
- Intracranial hemorrhagic events associated with flow diversion treatment: a retrospective analysis from a single academic institution.Neurosurgical review · 2025Article
- Challenges of the Endovascular Approach for Difficult Cerebral Aneurysms.Acta neurochirurgica. Supplement · 2025Article
- Cost-effectiveness of platelet function testing in dual antiplatelet therapy decision-making after intracranial aneurysm treatment with flow diversion.Neurosurgical review · 2024Article
- An increase in flow-diverter oversizing values as an independent risk factor for developing more severe in-stent stenosis. A retrospective single-center study based on flow diversion of supraclinoid internal carotid artery aneurysms.Frontiers in neurology · 2024Article
- Classification and hemodynamic characteristics of delayed intracerebral hemorrhage following stent-assisted coil embolism in unruptured intracranial aneurysms.Frontiers in neurology · 2024Article
- A case of middle cerebral artery large circumferential aneurysm treated with bypass-assisted trapping surgery.Nagoya journal of medical science · 2023Article
- Early clinical experience with the p48MW HPC and p64MW HPC flow diverters in the anterior circulation aneurysm using single anti-platelet treatment.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2022Article
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- Progressive volume reduction and long-term aneurysmal collapse following flow diversion treatment of giant and symptomatic cerebral aneurysms.Frontiers in neurology · 2022Article
- Imbalanced flow changes of distal arteries: An important factor in process of delayed ipsilateral parenchymal hemorrhage after flow diversion in patients with cerebral aneurysms.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2021Article
- The Combination of Stent and Antiplatelet Therapy May Be Responsible of Parenchymal Magnetic Susceptibility Artifacts after Endovascular Procedure.Tomography (Ann Arbor, Mich.) · 2021Article
- In-silico trial of intracranial flow diverters replicates and expands insights from conventional clinical trials.Nature communications · 2021Article
- Technical aspects of combined intrasaccular and endoluminal flow diversion.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2021Article
- Utilization of the Ballast Long Guiding Sheath for Neuroendovascular Procedures: Institutional Experience in 68 Cases.Frontiers in neurology · 2021Article
- Risk Factor Analysis of Delayed Intracerebral Hemorrhage After Coil Embolization of Unruptured Cerebral Aneurysms.Frontiers in neurology · 2020Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
background and purposeSpontaneous intraparenchymal hemorrhage is a dreaded complication of unknown etiology following flow-diversion treatment. Using the International Retrospective Study of the Pipeline Embolization Device registry, we studied demographic, aneurysm, and procedural characteristics associated with intraparenchymal hemorrhage following Pipeline Embolization Device treatment. MATERIALS AND
methodsWe identified patients in the International Retrospective Study of the Pipeline Embolization Device registry with intraparenchymal hemorrhage unrelated to index aneurysm rupture post-Pipeline Embolization Device treatment. The rate of intraparenchymal hemorrhage was determined by baseline demographics, comorbidities, aneurysm characteristics, and procedural characteristics (including anticoagulation use, platelet testing, number of devices used, sheaths, catheters, and guidewires). Categoric variables were compared with χ(2) testing, and continuous variables were compared with the Student t test.
resultsOf 793 patients with 906 aneurysms, 20 (2.5%) had intraparenchymal hemorrhage. Fifteen intraparenchymal hemorrhages (75.0%) occurred within 30 days of treatment (median, 5 days; range, 0-150 days). Nine patients with intraparenchymal hemorrhage (45.0%) died, 10 (50.0%) had major neurologic morbidity, and 1 had minor neurologic morbidity (5.0%). Intraparenchymal hemorrhage was ipsilateral to the Pipeline Embolization Device in 16 patients (80%) and contralateral in 3 patients (15.0%). Variables associated with higher odds of intraparenchymal hemorrhage included treatment of ruptured aneurysms (OR, 4.44; 95% CI, 1.65-11.94; P = .005) and the use of ≥ 3 Pipeline Embolization Devices (OR, 4.10; 95% CI, 1.34-12.58; P = .04). The Shuttle sheath was not associated with intraparenchymal hemorrhage (OR, 0.97; 95% CI, 0.38-2.45; P = .95).
conclusionsSpontaneous intraparenchymal hemorrhage following Pipeline Embolization Device treatment is a rare-but-devastating complication, with nearly all patients having morbidity or mortality. Variables associated with intraparenchymal hemorrhage included the use of multiple Pipeline Embolization Devices and treatment of ruptured aneurysms. The Shuttle, a device that was previously thought to be associated with intraparenchymal hemorrhage, was not associated with it.
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