{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T14:43:06Z","timestamp":1784385786455,"version":"3.55.0"},"reference-count":40,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:p>The Pipeline embolization device (PED) has become a very important tool in the treatment of nonruptured cerebral aneurysms. However, a patient\u2019s difficult anatomy or vascular stenosis may affect the device delivery. The purpose of this article was to describe an alternate technique for PED deployment when ipsilateral anatomy is not amenable for catheter navigation.<\/jats:p>\n                  <jats:p>A 44-year-old woman with a symptomatic 6-mm right superior hypophyseal artery aneurysm and a known history of right internal carotid artery dissection presented for PED treatment of her aneurysm. An angiogram showed persistence of the arterial dissection with luminal stenosis after 6 months of dual antiplatelet treatment. The contralateral internal carotid artery was catheterized and the PED was deployed via a transcirculation approach, using the anterior communicating artery. Transcirculation deployment of a PED is a viable option when ipsilateral anatomy is difficult or contraindicated for this treatment.<\/jats:p>","DOI":"10.3171\/2017.2.focus16485","type":"journal-article","created":{"date-parts":[[2017,6,1]],"date-time":"2017-06-01T03:36:47Z","timestamp":1496288207000},"page":"E13","source":"Crossref","is-referenced-by-count":7,"title":["Transcirculation Pipeline embolization device deployment: a rescue technique"],"prefix":"10.3171","volume":"42","author":[{"given":"Edison P.","family":"Valle-Giler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Atallah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stavropoula","family":"Tjoumakaris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert H.","family":"Rosenwasser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Jabbour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Neurosurgery","first-page":"820","article-title":"Transcirculation endovascular treatment of complex cerebral aneurysms: technical considerations and preliminary results","volume":"68","author":"Albuquerque FC","year":"2011","unstructured":"Albuquerque FC, Gonzalez LF, Hu YC, Newman CB, McDougall CG: Transcirculation endovascular treatment of complex cerebral aneurysms: technical considerations and preliminary results. Neurosurgery 68:820\u2013830, 2011"},{"key":"b2","series-title":"Radiology","first-page":"858","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. Radiology 267:858\u2013868, 2013"},{"key":"b3","series-title":"Stroke","first-page":"2150","article-title":"Comparison of flow diversion and coiling in large unruptured intracranial saccular aneurysms","volume":"44","author":"Chalouhi N","year":"2013","unstructured":"Chalouhi N, Tjoumakaris S, Starke RM, Gonzalez LF, Randazzo C, Hasan D, : Comparison of flow diversion and coiling in large unruptured intracranial saccular aneurysms. Stroke 44:2150\u20132154, 2013"},{"key":"b4","series-title":"Neurosurgery","first-page":"679","article-title":"Single center experience with Pipeline stent: feasibility, technique, and complications","volume":"71","author":"Chitale R","year":"2012","unstructured":"Chitale R, Gonzalez LF, Randazzo C, Dumont AS, Tjoumakaris S, Rosenwasser R, : Single center experience with Pipeline stent: feasibility, technique, and complications. Neurosurgery 71:679\u2013691, 2012"},{"key":"b5","series-title":"J Neurointerv Surg","first-page":"56","article-title":"Curative cerebrovascular reconstruction with the Pipeline Embolization Device: the emergence of definitive endovascular therapy for intracranial aneurysms","volume":"1","author":"Fiorella D","year":"2009","unstructured":"Fiorella D, Lylyk P, Szikora I, Kelly ME, Albuquerque FC, McDougall CG, : Curative cerebrovascular reconstruction with the Pipeline Embolization Device: the emergence of definitive endovascular therapy for intracranial aneurysms. J Neurointerv Surg 1:56\u201365, 2009"},{"key":"b6","series-title":"Neuroradiology","first-page":"369","article-title":"Pipeline Embolization Device (PED) for neurovascular reconstruction: initial experience in the treatment of 101 intracranial aneurysms and dissections","volume":"54","author":"Fischer S","year":"2012","unstructured":"Fischer S, Vajda Z, Aguilar Perez M, Schmid E, Hopf N, B\u00e4zner H, : Pipeline Embolization Device (PED) for neurovascular reconstruction: initial experience in the treatment of 101 intracranial aneurysms and dissections. Neuroradiology 54:369\u2013382, 2012"},{"key":"b7","series-title":"Neurosurgery","first-page":"1216","article-title":"Aneurysm rupture after parent vessel sacrifice: treatment with Guglielmi detachable coil embolization via retrograde catheterization: case report","volume":"37","author":"Gurian JH","year":"1995","unstructured":"Gurian JH, Vi\u00f1uela F, Gobin YP, Waston VE, Duckwiler GR, Gulielmi G: Aneurysm rupture after parent vessel sacrifice: treatment with Guglielmi detachable coil embolization via retrograde catheterization: case report. Neurosurgery 37:1216\u20131221, 1995"},{"key":"b8","series-title":"J Neurointerv Surg","first-page":"824","article-title":"Retrograde access to the posterior inferior cerebellar artery in balloon-assisted coiling of posterior inferior cerebellar artery aneurysms","volume":"7","author":"Heye S","year":"2015","unstructured":"Heye S, Stracke CP, Nordmeyer H, Heddier M, Stauder M, Chapot R: Retrograde access to the posterior inferior cerebellar artery in balloon-assisted coiling of posterior inferior cerebellar artery aneurysms. J Neurointerv Surg 7:824\u2013828, 2015"},{"key":"b9","series-title":"Neurosurgery","first-page":"113","article-title":"The Pipeline Embolization Device: learning curve and predictors of complications and aneurysm obliteration","volume":"73","author":"Jabbour P","year":"2013","unstructured":"Jabbour P, Chalouhi N, Tjoumakaris S, Gonzalez LF, Dumont AS, Randazzo C, : The Pipeline Embolization Device: learning curve and predictors of complications and aneurysm obliteration. Neurosurgery 73:113\u2013120, 2013"},{"key":"b10","series-title":"AJNR Am J Neuroradiol","first-page":"108","article-title":"International retrospective study of the Pipeline Embolization Device: a multicenter aneurysm treatment study","volume":"36","author":"Kallmes DF","year":"2015","unstructured":"Kallmes DF, Hanel R, Lopes D, Boccardi E, Bonaf\u00e9 A, Cekirge S, : International retrospective study of the Pipeline Embolization Device: a multicenter aneurysm treatment study. AJNR Am J Neuroradiol 36:108\u2013115, 2015"},{"key":"b11","series-title":"Interv Neuroradiol","first-page":"44","article-title":"Coiling of a recurrent broad-necked posterior communicating aneurysm incorporating a fetal cerebral artery: a technical case report","volume":"21","author":"Kim YJ","year":"2015","unstructured":"Kim YJ, Ho Ko J: Coiling of a recurrent broad-necked posterior communicating aneurysm incorporating a fetal cerebral artery: a technical case report. Interv Neuroradiol 21:44\u201349, 2015"},{"key":"b12","series-title":"Neuroradiology","first-page":"99","article-title":"Endovascular treatment of proximal anterior cerebral artery aneurysms","volume":"51","author":"Lubicz B","year":"2009","unstructured":"Lubicz B, Bruneau M, Dewindt A, Lefranc F, Bal\u00e9riaux D, De Witte O: Endovascular treatment of proximal anterior cerebral artery aneurysms. Neuroradiology 51:99\u2013102, 2009"},{"key":"b13","series-title":"Neurosurgery","first-page":"632","article-title":"Curative endovascular reconstruction of cerebral aneurysms with the Pipeline Embolization Device: the Buenos Aires experience","volume":"64","author":"Lylyk P","unstructured":"Lylyk P, Miranda C, Ceratto R, Ferrario A, Scrivano E, Luna HR, : Curative endovascular reconstruction of cerebral aneurysms with the Pipeline Embolization Device: the Buenos Aires experience. Neurosurgery 64:632\u2013633, N636, 2009"},{"key":"b14","series-title":"AJNR Am J Neuroradiol","first-page":"1779","article-title":"Enhanced aneurysmal flow diversion using a dynamic push-pull technique: an experimental and modeling study","volume":"35","author":"Ma D","year":"2014","unstructured":"Ma D, Xiang J, Choi H, Dumont TM, Natarajan SK, Siddiqui AH, : Enhanced aneurysmal flow diversion using a dynamic push-pull technique: an experimental and modeling study. 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J Neurointerv Surg 7:351\u2013356, 2015"},{"key":"b20","series-title":"Interv Neuroradiol","first-page":"81","article-title":"Unusual intracranial stent navigation through the circle of Willis in a patient with recurrent basilar tip aneurysm during stent-assisted coiling. A case report","volume":"15","author":"Puri AS","year":"2009","unstructured":"Puri AS, Erdem E: Unusual intracranial stent navigation through the circle of Willis in a patient with recurrent basilar tip aneurysm during stent-assisted coiling. A case report. 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Neurosurgery 71:679\u2013691, 2012"},{"key":"b5","series-title":"J Neurointerv Surg","first-page":"56","article-title":"Curative cerebrovascular reconstruction with the Pipeline Embolization Device: the emergence of definitive endovascular therapy for intracranial aneurysms","volume":"1","author":"Fiorella D","year":"2009","unstructured":"Fiorella D, Lylyk P, Szikora I, Kelly ME, Albuquerque FC, McDougall CG, : Curative cerebrovascular reconstruction with the Pipeline Embolization Device: the emergence of definitive endovascular therapy for intracranial aneurysms. J Neurointerv Surg 1:56\u201365, 2009"},{"key":"b6","series-title":"Neuroradiology","first-page":"369","article-title":"Pipeline Embolization Device (PED) for neurovascular reconstruction: initial experience in the treatment of 101 intracranial aneurysms and dissections","volume":"54","author":"Fischer S","year":"2012","unstructured":"Fischer S, Vajda Z, Aguilar Perez M, Schmid E, Hopf N, B\u00e4zner H, : Pipeline Embolization Device (PED) for neurovascular reconstruction: initial experience in the treatment of 101 intracranial aneurysms and dissections. 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Neurosurgery 37:1216\u20131221, 1995"},{"key":"b8","series-title":"J Neurointerv Surg","first-page":"824","article-title":"Retrograde access to the posterior inferior cerebellar artery in balloon-assisted coiling of posterior inferior cerebellar artery aneurysms","volume":"7","author":"Heye S","year":"2015","unstructured":"Heye S, Stracke CP, Nordmeyer H, Heddier M, Stauder M, Chapot R: Retrograde access to the posterior inferior cerebellar artery in balloon-assisted coiling of posterior inferior cerebellar artery aneurysms. J Neurointerv Surg 7:824\u2013828, 2015"},{"key":"b9","series-title":"Neurosurgery","first-page":"113","article-title":"The Pipeline Embolization Device: learning curve and predictors of complications and aneurysm obliteration","volume":"73","author":"Jabbour P","year":"2013","unstructured":"Jabbour P, Chalouhi N, Tjoumakaris S, Gonzalez LF, Dumont AS, Randazzo C, : The Pipeline Embolization Device: learning curve and predictors of complications and aneurysm obliteration. Neurosurgery 73:113\u2013120, 2013"},{"key":"b10","series-title":"AJNR Am J Neuroradiol","first-page":"108","article-title":"International retrospective study of the Pipeline Embolization Device: a multicenter aneurysm treatment study","volume":"36","author":"Kallmes DF","year":"2015","unstructured":"Kallmes DF, Hanel R, Lopes D, Boccardi E, Bonaf\u00e9 A, Cekirge S, : International retrospective study of the Pipeline Embolization Device: a multicenter aneurysm treatment study. AJNR Am J Neuroradiol 36:108\u2013115, 2015"},{"key":"b11","series-title":"Interv Neuroradiol","first-page":"44","article-title":"Coiling of a recurrent broad-necked posterior communicating aneurysm incorporating a fetal cerebral artery: a technical case report","volume":"21","author":"Kim YJ","year":"2015","unstructured":"Kim YJ, Ho Ko J: Coiling of a recurrent broad-necked posterior communicating aneurysm incorporating a fetal cerebral artery: a technical case report. Interv Neuroradiol 21:44\u201349, 2015"},{"key":"b12","series-title":"Neuroradiology","first-page":"99","article-title":"Endovascular treatment of proximal anterior cerebral artery aneurysms","volume":"51","author":"Lubicz B","year":"2009","unstructured":"Lubicz B, Bruneau M, Dewindt A, Lefranc F, Bal\u00e9riaux D, De Witte O: Endovascular treatment of proximal anterior cerebral artery aneurysms. Neuroradiology 51:99\u2013102, 2009"},{"key":"b13","series-title":"Neurosurgery","first-page":"632","article-title":"Curative endovascular reconstruction of cerebral aneurysms with the Pipeline Embolization Device: the Buenos Aires experience","volume":"64","author":"Lylyk P","unstructured":"Lylyk P, Miranda C, Ceratto R, Ferrario A, Scrivano E, Luna HR, : Curative endovascular reconstruction of cerebral aneurysms with the Pipeline Embolization Device: the Buenos Aires experience. Neurosurgery 64:632\u2013633, N636, 2009"},{"key":"b14","series-title":"AJNR Am J Neuroradiol","first-page":"1779","article-title":"Enhanced aneurysmal flow diversion using a dynamic push-pull technique: an experimental and modeling study","volume":"35","author":"Ma D","year":"2014","unstructured":"Ma D, Xiang J, Choi H, Dumont TM, Natarajan SK, Siddiqui AH, : Enhanced aneurysmal flow diversion using a dynamic push-pull technique: an experimental and modeling study. AJNR Am J Neuroradiol 35:1779\u20131785, 2014"},{"key":"b15","series-title":"Lancet","first-page":"809","article-title":"International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion","volume":"366","author":"Molyneux AJ","year":"2005","unstructured":"Molyneux AJ, Kerr RSC, Yu LM, Clarke M, Sneade M, Yarnold JA, : International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet 366:809\u2013817, 2005"},{"key":"b16","series-title":"AJNR Am J Neuroradiol","first-page":"262","article-title":"The retrograde approach: a consideration for the endovascular treatment of aneurysms","volume":"21","author":"Moret J","year":"2000","unstructured":"Moret J, Ross IB, Weill A, Piotin M: The retrograde approach: a consideration for the endovascular treatment of aneurysms. AJNR Am J Neuroradiol 21:262\u2013268, 2000"},{"key":"b17","series-title":"J Neurointerv Surg","first-page":"e7","article-title":"Retrograde trans-anterior communicating artery rescue of unopened Pipeline Embolization Device with balloon dilation: complication management","volume":"7","author":"Navarro R","year":"2015","unstructured":"Navarro R, Yoon J, Dixon T, Miller DA, Hanel RA, Tawk RG: Retrograde trans-anterior communicating artery rescue of unopened Pipeline Embolization Device with balloon dilation: complication management. J Neurointerv Surg 7:e7, 2015"},{"key":"b18","series-title":"AJNR Am J Neuroradiol","first-page":"34","article-title":"The Pipeline Embolization Device for the intracranial treatment of aneurysms trial","volume":"32","author":"Nelson PK","year":"2011","unstructured":"Nelson PK, Lylyk P, Szikora I, Wetzel SG, Wanke I, Fiorella D: The Pipeline Embolization Device for the intracranial treatment of aneurysms trial. AJNR Am J Neuroradiol 32:34\u201340, 2011"},{"key":"b19","series-title":"J Neurointerv Surg","first-page":"351","article-title":"Modifying flow in the ACA-ACoA complex: endovascular treatment option for wide-neck internal carotid artery bifurcation aneurysms","volume":"7","author":"Nossek E","year":"2015","unstructured":"Nossek E, Chalif DJ, Levine M, Setton A: Modifying flow in the ACA-ACoA complex: endovascular treatment option for wide-neck internal carotid artery bifurcation aneurysms. J Neurointerv Surg 7:351\u2013356, 2015"},{"key":"b20","series-title":"Interv Neuroradiol","first-page":"81","article-title":"Unusual intracranial stent navigation through the circle of Willis in a patient with recurrent basilar tip aneurysm during stent-assisted coiling. A case report","volume":"15","author":"Puri AS","year":"2009","unstructured":"Puri AS, Erdem E: Unusual intracranial stent navigation through the circle of Willis in a patient with recurrent basilar tip aneurysm during stent-assisted coiling. A case report. 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