ArticleAJNR. American journal of neuroradiology2020
Implications of the Collar Sign in Incompletely Occluded Aneurysms after Pipeline Embolization Device Implantation: A Follow-Up Study.
Article in AJNR. American journal of neuroradiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed, 3 citations in OpenAlex.
- Retreatment of previously flow diverted intracranial aneurysms with the pipeline embolization device.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2023Article
- The Collar Sign in Pipeline Embolization Device-Treated Aneurysms.AJNR. American journal of neuroradiology · 2020Article
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeThe angiographic collar sign has been recently described in patients with incompletely occluded aneurysms after Pipeline Embolization Device implantation. The long-term implications of this sign are unknown. We report angiographic outcomes of patients with the collar sign with follow-up of up to 45 months and the implications of this angiographic finding. MATERIALS AND
methodsWe performed a retrospective review of a prospectively maintained data base of patients who underwent Pipeline Embolization Device implantation for an intracranial aneurysm at our institution between January 2014 and December 2016. We included patients with a collar sign at the initial follow-up angiogram after Pipeline Embolization Device implantation.
resultsA total of 198 patients with 285 aneurysms were screened for the collar sign on initial and subsequent follow-up angiograms. There were 226 aneurysms (79.3%) with complete occlusion at the first follow-up. Of 59 incompletely occluded aneurysms, 19 (32.2%) aneurysms in 17 patients were found to have a collar sign on the first angiographic follow-up (median, 6 months; range, 4.2-7.2). Ten (52.6%) aneurysms underwent retreatment with a second Pipeline Embolization Device, which resulted in aneurysm occlusion in 1 (10%) patient. There were only 3 (15.8%) aneurysms with complete occlusion at the last follow-up, 2 (10.5%) of which had a single Pipeline Embolization Device implantation and another single (5.3%) aneurysm with a second Pipeline Embolization Device implantation.
conclusionsA collar sign on the initial angiogram after Pipeline Embolization Device placement is a predictor of poor aneurysm occlusion. Because the occlusion rates remain equally low regardless of retreatment in patients with a collar sign, radiologic follow-up may be more appropriate than retreatment.
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