{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T13:09:02Z","timestamp":1790860142107,"version":"4.1.0"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T00:00:00Z","timestamp":1576800000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurosurg.","NEUROS"],"published-print":{"date-parts":[[2020,10]]},"abstract":"Abstract<\/jats:title>\n \n BACKGROUND<\/jats:title>\n A dramatic improvement in obliteration rates of large, wide-necked aneurysms has been observed after the FDA approved the Pipeline Embolization Device (PED) in 2011.<\/jats:p>\n <\/jats:sec>\n \n OBJECTIVE<\/jats:title>\n To assess the predictors of complications, morbidity, and unfavorable outcomes in a large cohort of patients with aneurysms treated with PED.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n A retrospective chart review of a prospectively maintained database for subjects treated with flow diversion from 2010 to 2019.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n A total of 598 aneurysms were treated during a period extending from 2010 to 2019 (84.28% females, mean age 55.5 yr, average aneurysm size 8.49 mm). Morbidity occurred at a rate of 5.8% and mortality at a rate of 2.2%. Ischemic stroke occurred at a rate of 3%, delayed aneurysmal rupture (DAR) at 1.2%, and distal intraparenchymal hemorrhage (DIPH) at 1.5%. On multivariate analysis, the predictor of stroke was aneurysm size\u00a0>15 mm. Predictors of DAR were previous subarachnoid hemorrhage (SAH), increasing aneurysm size, and posterior circulation aneurysm. Predictors of DIPH were using more than 1 PED and baseline P2Y12 value. Predictors of in-stent stenosis were the increasing year of treatment and balloon angioplasty, whereas increasing age and previous treatment were negatively associated with in-stent stenosis. Predictors of morbidity were posterior circulation aneurysms, increasing aneurysm size, and hypertension, and incidental aneurysm diagnosis was protective for morbidity.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSION<\/jats:title>\n Flow diversion is a safe and effective treatment option for aneurysms. A better understanding of predictive factors of complications, morbidity, and functional outcomes is of high importance for a more accurate risk assessment.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/neuros\/nyz508","type":"journal-article","created":{"date-parts":[[2019,10,29]],"date-time":"2019-10-29T08:15:05Z","timestamp":1572336905000},"page":"730-743","source":"Crossref","is-referenced-by-count":51,"title":["Predictors of Complications, Functional Outcome, and Morbidity in a Large Cohort Treated With Flow Diversion"],"prefix":"10.1227","volume":"87","author":[{"given":"Ahmad","family":"Sweid","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Jefferson Hospital for Neuroscience, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert M","family":"Starke","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Miami Hospital, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabeel","family":"Herial","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jefferson Hospital for Neuroscience, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nohra","family":"Chalouhi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jefferson Hospital for Neuroscience, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Somnath","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jefferson Hospital for Neuroscience, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P","family":"Baldassari","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jefferson 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