{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T16:21:48Z","timestamp":1791044508834,"version":"4.1.0"},"reference-count":25,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>The Pipeline Embolization Device (PED) is now a well-established option for the treatment of giant or complex aneurysms, especially those arising from the anterior circulation. Considering the purpose of such treatment is to maintain patency of the parent vessel, postembolization occlusion of the parent artery can be regarded as an untoward outcome. Antiplatelet therapy in the posttreatment period is therefore required to minimize such events. Here, the authors present a series of patients with anterior circulation aneurysms treated with the PED who subsequently experienced parent vessel occlusion (PVO).<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The authors performed a retrospective review of all anterior circulation aneurysms consecutively treated at a single institution with the PED through 2014, identifying those with PVO on follow-up imaging. Aneurysm size and location, number of PEDs used, and follow-up digital subtraction angiography results were recorded. When available, pre- and postembolization platelet function testing results were also recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Among 256 patients with anterior circulation aneurysms treated with the PED, the authors identified 8 who developed PVO after embolization. The mean aneurysm size in this cohort was 22.3 mm, and the number of PEDs used per case ranged from 2 to 10. Six patients were found to have asymptomatic PVO discovered incidentally on routine follow-up imaging between 6 months and 3 years postembolization, 3 of whom had documented \u201cdelayed\u201d PVO with prior postembolization angiograms confirming aneurysm occlusion and a patent parent vessel at an earlier time. Two additional patients experienced symptomatic PVO, one of which was associated with early discontinuation of antiplatelet therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>In this large series of anterior circulation aneurysms, the authors report a low incidence of symptomatic PVO, complicating premature discontinuation of postembolization antiplatelet or anticoagulation therapy. Beyond the subacute period, asymptomatic PVO was more common, particularly among complex fusiform or very large\u2013necked aneurysms, highlighting an important phenomenon with the use of PED for the treatment of anterior circulation aneurysms, and suggesting that extended periods of antiplatelet coverage may be required in select complex aneurysms.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2016.9.jns152638","type":"journal-article","created":{"date-parts":[[2017,1,6]],"date-time":"2017-01-06T15:01:14Z","timestamp":1483714874000},"page":"1333-1341","source":"Crossref","is-referenced-by-count":19,"title":["Parent vessel occlusion after Pipeline embolization of cerebral aneurysms of the anterior circulation"],"prefix":"10.3171","volume":"127","author":[{"given":"Matthew B.","family":"Potts","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and Radiology, Division of Cerebrovascular\/Neurointerventional Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maksim","family":"Shapiro","sequence":"additional","affiliation":[{"name":"Departments of Radiology,"},{"name":"Neurology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel W.","family":"Zumofen","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and Radiology, Universit\u00e4tsspital Basel, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eytan","family":"Raz","sequence":"additional","affiliation":[{"name":"Departments of Radiology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erez","family":"Nossek","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Maimonides Medical Center, Brooklyn, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith G.","family":"DeSousa","sequence":"additional","affiliation":[{"name":"Departments of Radiology,"},{"name":"Neurology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tibor","family":"Becske","sequence":"additional","affiliation":[{"name":"Department of Neurology, Rochester General Hospital, Rochester, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard A.","family":"Riina","sequence":"additional","affiliation":[{"name":"Departments of Radiology,"},{"name":"Neurological Surgery, Bernard and Irene Schwartz Neurointerventional Radiology Section, New York University Langone School of Medicine, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter K.","family":"Nelson","sequence":"additional","affiliation":[{"name":"Departments of Radiology,"},{"name":"Neurological Surgery, Bernard and Irene Schwartz Neurointerventional Radiology Section, New York University Langone School of Medicine, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns152638","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1148\/radiol.13120099","article-title":"Pipeline for uncoilable or failed aneurysms: results from a multicenter clinical trial","volume":"267","author":"Becske T,","year":"2013","unstructured":"Becske T, Kallmes DF, Saatci I, McDougall CG, Szikora I, Lanzino G, : Pipeline for uncoilable or failed aneurysms: results from a multicenter clinical trial. 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