TY - JOUR
T1 - Neuroophthalmological outcomes associated with use of the Pipeline Embolization Device
T2 - Analysis of the PUFS trial results
AU - Sahlein, Daniel H.
AU - Fouladvand, Mohammad
AU - Becske, Tibor
AU - Saatci, Isil
AU - McDougall, Cameron G.
AU - Szikora, István
AU - Lanzino, Giuseppe
AU - Moran, Christopher J.
AU - Woo, Henry H.
AU - Lopes, Demetrius K.
AU - Berez, Aaron L.
AU - Cher, Daniel J.
AU - Siddiqui, Adnan H.
AU - Levy, Elad I.
AU - Albuquerque, Felipe C.
AU - Fiorella, David J.
AU - Berentei, Zsolt
AU - Marosfoi, Miklos
AU - Cekirge, Saruhan H.
AU - Kallmes, David F.
AU - Nelson, Peter K.
N1 - Publisher Copyright:
© AANS, 2015.
PY - 2015/10
Y1 - 2015/10
N2 - Object Neuroophthalmological morbidity is commonly associated with large and giant cavernous and supraclinoid internal carotid artery (ICA) aneurysms. The authors sought to evaluate the neuroophthalmological outcomes after treatment of these aneurysms with the Pipeline Embolization Device (PED). Methods The Pipeline for Uncoilable or Failed Aneurysms (PUFS) trial was an international, multicenter prospective trial evaluating the safety and efficacy of the PED. All patients underwent complete neuroophthalmological examinations both before the PED procedure and at a 6-month follow-up. All examinations were performed for the purpose of this study and according to study criteria. Results In total, 108 patients were treated in the PUFS trial, 98 of whom had complete neuroophthalmological follow-up. Of the patients with complete follow-up, 39 (40%) presented with a neuroophthalmological baseline deficit that was presumed to be attributable to the aneurysm, and patients with these baseline deficits had significantly larger aneurysms. In 25 of these patients (64%), the baseline deficit showed at least some improvement 6 months after PED treatment, whereas in 1 patient (2.6%), the deficits only worsened. In 5 patients (5%), new deficits had developed at the 6-month follow-up, while in another 6 patients (6%), deficits that were not originally assumed to be related to the aneurysm had improved by that time. A history of diabetes was associated with failure of the baseline deficits to improve after the treatment. The aneurysm maximum diameter was significantly larger in patients with a new deficit or a worse baseline deficit at 6 months postprocedure. Conclusions Patients treated with the PED for large and giant ICA aneurysms had excellent neuroophthalmological outcomes 6 months after the procedure, with deficits improving in most of the patients, very few deficits worsening, and few new deficits developing.
AB - Object Neuroophthalmological morbidity is commonly associated with large and giant cavernous and supraclinoid internal carotid artery (ICA) aneurysms. The authors sought to evaluate the neuroophthalmological outcomes after treatment of these aneurysms with the Pipeline Embolization Device (PED). Methods The Pipeline for Uncoilable or Failed Aneurysms (PUFS) trial was an international, multicenter prospective trial evaluating the safety and efficacy of the PED. All patients underwent complete neuroophthalmological examinations both before the PED procedure and at a 6-month follow-up. All examinations were performed for the purpose of this study and according to study criteria. Results In total, 108 patients were treated in the PUFS trial, 98 of whom had complete neuroophthalmological follow-up. Of the patients with complete follow-up, 39 (40%) presented with a neuroophthalmological baseline deficit that was presumed to be attributable to the aneurysm, and patients with these baseline deficits had significantly larger aneurysms. In 25 of these patients (64%), the baseline deficit showed at least some improvement 6 months after PED treatment, whereas in 1 patient (2.6%), the deficits only worsened. In 5 patients (5%), new deficits had developed at the 6-month follow-up, while in another 6 patients (6%), deficits that were not originally assumed to be related to the aneurysm had improved by that time. A history of diabetes was associated with failure of the baseline deficits to improve after the treatment. The aneurysm maximum diameter was significantly larger in patients with a new deficit or a worse baseline deficit at 6 months postprocedure. Conclusions Patients treated with the PED for large and giant ICA aneurysms had excellent neuroophthalmological outcomes 6 months after the procedure, with deficits improving in most of the patients, very few deficits worsening, and few new deficits developing.
KW - Aneurysm
KW - Aneurysm embolization
KW - Flow diversion
KW - Neuroophthalmology
KW - Pipeline Embolization Device
KW - Vascular disorders
UR - http://www.scopus.com/inward/record.url?scp=84953343122&partnerID=8YFLogxK
U2 - 10.3171/2014.12.JNS141777
DO - 10.3171/2014.12.JNS141777
M3 - Article
C2 - 26162031
AN - SCOPUS:84953343122
SN - 0022-3085
VL - 123
SP - 897
EP - 905
JO - Journal of neurosurgery
JF - Journal of neurosurgery
IS - 4
ER -