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Research ArticleNeurointervention

Multicenter Experience with the Pipeline Flex and Vantage with Shield Technology for Intracranial Aneurysm Treatment

Lukas Goertz, Sophia Hohenstatt, Dominik F. Vollherbst, Muriel Pflaeging, Christian Gronemann, Eberhard Siebert, David Zopfs, Lenhard Pennig, Jonathan Kottlors, Marc Schlamann, Georg Bohner, Franziska Dorn, Thomas Liebig, Markus Möhlenbruch and Christoph Kabbasch
American Journal of Neuroradiology October 2024, 45 (10) 1488-1494; DOI: https://doi.org/10.3174/ajnr.A8352
Lukas Goertz
aFrom the Department of Radiology and Neuroradiology (L.G., D.Z., L.P., J.K., M.S., C.K.), University of Cologne, Faculty of Medicine and University Hospital, Cologne, Germany
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  • ORCID record for Lukas Goertz
Sophia Hohenstatt
bDepartment of Neuroradiology (S.H., D.F.V., M.M.), University Hospital Heidelberg, Heidelberg, Germany
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  • ORCID record for Sophia Hohenstatt
Dominik F. Vollherbst
bDepartment of Neuroradiology (S.H., D.F.V., M.M.), University Hospital Heidelberg, Heidelberg, Germany
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  • ORCID record for Dominik F. Vollherbst
Muriel Pflaeging
cDepartment of Neuroradiology (M.P., T.L.), University Hospital Munich, Munich, Germany
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  • ORCID record for Muriel Pflaeging
Christian Gronemann
dDepartment of Neuroradiology (C.G., F.D.), University Hospital Bonn, Bonn, Germany
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Eberhard Siebert
eDepartment of Neuroradiology (E.S., G.B.), University Hospital Berlin (Charité), Berlin, Germany
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  • ORCID record for Eberhard Siebert
David Zopfs
aFrom the Department of Radiology and Neuroradiology (L.G., D.Z., L.P., J.K., M.S., C.K.), University of Cologne, Faculty of Medicine and University Hospital, Cologne, Germany
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Lenhard Pennig
aFrom the Department of Radiology and Neuroradiology (L.G., D.Z., L.P., J.K., M.S., C.K.), University of Cologne, Faculty of Medicine and University Hospital, Cologne, Germany
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Jonathan Kottlors
aFrom the Department of Radiology and Neuroradiology (L.G., D.Z., L.P., J.K., M.S., C.K.), University of Cologne, Faculty of Medicine and University Hospital, Cologne, Germany
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Marc Schlamann
aFrom the Department of Radiology and Neuroradiology (L.G., D.Z., L.P., J.K., M.S., C.K.), University of Cologne, Faculty of Medicine and University Hospital, Cologne, Germany
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Georg Bohner
eDepartment of Neuroradiology (E.S., G.B.), University Hospital Berlin (Charité), Berlin, Germany
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Franziska Dorn
dDepartment of Neuroradiology (C.G., F.D.), University Hospital Bonn, Bonn, Germany
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Thomas Liebig
cDepartment of Neuroradiology (M.P., T.L.), University Hospital Munich, Munich, Germany
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Markus Möhlenbruch
bDepartment of Neuroradiology (S.H., D.F.V., M.M.), University Hospital Heidelberg, Heidelberg, Germany
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Christoph Kabbasch
aFrom the Department of Radiology and Neuroradiology (L.G., D.Z., L.P., J.K., M.S., C.K.), University of Cologne, Faculty of Medicine and University Hospital, Cologne, Germany
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Abstract

BACKGROUND AND PURPOSE: The Pipeline Embolization Device is a safe and effective treatment option for intracranial aneurysms. The newer Pipeline generations have received structural refinements and a surface modification to improve deliverability, procedural safety, and angiographic outcomes. This multicenter study evaluated the clinical safety and efficacy of the 2 surface-modified Pipeline iterations, Pipeline Vantage and Pipeline Flex with Shield Technology (PFS).

MATERIALS AND METHODS: Consecutive patients treated between 2017 and 2023 were retrospectively reviewed for aneurysm characteristics, procedural details, complications, and angiographic outcomes. The safety end point was the rate of procedural and postprocedural major neurologic events occurring during the hospital stay. The efficacy end point was the rate of complete occlusion at last follow-up.

RESULTS: One hundred forty-one patients underwent 112 Pipeline Vantage procedures and 32 PFS procedures for 147 aneurysms with a mean size of 8.0 (SD, 5.9) mm (11% ruptured, 16% posterior circulation, 18% nonsaccular morphology). All procedures were technically successful with a mean of 1.2 devices implanted. Balloon angioplasty was required in 20/144 (13.9%) procedures. Major neurologic adverse events occurred in 6/144 (4.2%) procedures (all ischemic stroke), resulting in death in 2 (1.4%) patients. There were no hemorrhagic complications. At a mean of 11 months, complete occlusion was achieved in 85/112 (75.9%) aneurysms, 15/112 (13.4%) had an entry remnant, and 12/112 (10.7%) had an aneurysm remnant.

CONCLUSIONS: The results demonstrate high feasibility, procedural safety, and efficacy of the surface-modified Pipeline flow diverters.

ABBREVIATIONS:

ASA
acetylsalicylic acid
BA
basilar artery
DAPT
dual antiplatelet therapy
FD
flow diverter
FU
follow-up
OKM
O’Kelly-Marotta scale
OR
odds ratio
PFS
Pipeline Flex with Shield Technology
PV
Pipeline Vantage
SAPT
single antiplatelet therapy
  • © 2024 by American Journal of Neuroradiology
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American Journal of Neuroradiology: 45 (10)
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Vol. 45, Issue 10
1 Oct 2024
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Cite this article
Lukas Goertz, Sophia Hohenstatt, Dominik F. Vollherbst, Muriel Pflaeging, Christian Gronemann, Eberhard Siebert, David Zopfs, Lenhard Pennig, Jonathan Kottlors, Marc Schlamann, Georg Bohner, Franziska Dorn, Thomas Liebig, Markus Möhlenbruch, Christoph Kabbasch
Multicenter Experience with the Pipeline Flex and Vantage with Shield Technology for Intracranial Aneurysm Treatment
American Journal of Neuroradiology Oct 2024, 45 (10) 1488-1494; DOI: 10.3174/ajnr.A8352

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Pipeline Flex & Vantage for Aneurysm Treatment
Lukas Goertz, Sophia Hohenstatt, Dominik F. Vollherbst, Muriel Pflaeging, Christian Gronemann, Eberhard Siebert, David Zopfs, Lenhard Pennig, Jonathan Kottlors, Marc Schlamann, Georg Bohner, Franziska Dorn, Thomas Liebig, Markus Möhlenbruch, Christoph Kabbasch
American Journal of Neuroradiology Oct 2024, 45 (10) 1488-1494; DOI: 10.3174/ajnr.A8352
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