{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:02:51Z","timestamp":1787025771232,"version":"build-2736575974"},"reference-count":54,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Flow diverter devices have revolutionized the treatment of intracranial aneurysms (IAs) since their approval in 2011 and have continued to evolve. The devices have been widely adopted across institutions and centers over the past decade; however, long-term follow-up after treatment with the Pipeline embolization device (PED) is not well described in the literature. The authors\u2019 institution was among the first to begin using PEDs, allowing them to report their series of patients treated with flow diverters \u2265 10 years ago. In this study, the authors aimed to evaluate the long-term angiographic and clinical outcomes of these patients and review lessons learned along the way.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The authors performed a retrospective review of their institution\u2019s IA database from January 2007 to July 2012. All patients with IAs treated with a PED prior to July 2012 were included. Clinical and angiographic characteristics were extracted. Available angiographic follow-up at 1, 3, 5, and 10 years was reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 83 patients with 92 aneurysms treated with a PED \u2265 10 years ago were identified and included in the study. The mean aneurysm dome diameter was 9.2 (SD 5.7) mm, the mean aneurysm height was 10.4 (SD 6.8) mm, and the mean neck width was 4.1 (SD 2.4) mm. Only 1 (1.1%) aneurysm was ruptured at presentation. Eight (8.7%) aneurysms were recurrences of previous treatment modalities. The morphology was saccular in 77 (83.7%) aneurysms, fusiform in 14 (15.2%), and blister-like in 1 (1.1%). Among saccular aneurysms, 60 (77.9%) were wide-necked. Seventy-five (81.5%) aneurysms were in the internal carotid artery, 12 (13.0%) were vertebrobasilar, 3 (3.3%) were in the middle cerebral artery, and 2 (2.2%) were in the posterior cerebral artery. Angiographic follow-up at 1, 3, 5, and 10 years was available for 75, 59, 50, and 15 patients, respectively. The complete occlusion rates at 1, 3, 5, and 10 years were 94.7%, 96.6%, 96.0%, and 100%, respectively. The retreatment rates at 1, 3, 5, and 10 years were 8.0%, 6.8%, 8.0%, and 6.7%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The authors provide their single-institution series of IA patients treated with a PED \u2265 10 years ago, with the first report of 10-year follow-up for the available patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2023.2.focus22646","type":"journal-article","created":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T07:19:56Z","timestamp":1682925596000},"page":"E2","source":"Crossref","is-referenced-by-count":12,"title":["The first decade of flow diversion for intracranial aneurysms with the Pipeline embolization device"],"prefix":"10.3171","volume":"54","author":[{"given":"Andre","family":"Monteiro","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaims","family":"Lim","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manhal","family":"Siddiqi","sequence":"additional","affiliation":[{"name":"Jacobs School of Medicine and Biomedical Sciences, University at Buffalo; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brianna M.","family":"Donnelly","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wasiq","family":"Khawar","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ammad","family":"Baig","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan C.","family":"Turner","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehdi","family":"Bouslama","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunal P.","family":"Raygor","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pui Man Rosalind","family":"Lai","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven B.","family":"Housley","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason M.","family":"Davies","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo;"},{"name":"Jacobs Institute, Buffalo;"},{"name":"Canon Stroke and Vascular Research Center, University at Buffalo, New York"},{"name":"Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth V.","family":"Snyder","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo;"},{"name":"Jacobs Institute, Buffalo;"},{"name":"Canon Stroke and Vascular Research Center, University at Buffalo, New York"},{"name":"Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adnan H.","family":"Siddiqui","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo;"},{"name":"Jacobs Institute, Buffalo;"},{"name":"Canon Stroke and Vascular Research Center, University at Buffalo, New York"},{"name":"Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elad I.","family":"Levy","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo;"},{"name":"Jacobs Institute, Buffalo;"},{"name":"Canon Stroke and Vascular Research Center, University at Buffalo, New York"},{"name":"Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","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","year":"2009","unstructured":"Lylyk P, Miranda C, Ceratto R,  Curative endovascular reconstruction of cerebral aneurysms with the Pipeline embolization device: the Buenos Aires experience. Neurosurgery. 2009;64(4):632\u2013643."},{"issue":"6","key":"b2","series-title":"AJNR Am J Neuroradiol","first-page":"1139","article-title":"Treatment of intracranial aneurysms by functional reconstruction of the parent artery: the Budapest experience with the pipeline embolization device","volume":"31","author":"Szikora I","year":"2010","unstructured":"Szikora I, Berentei Z, Kulcsar Z,  Treatment of intracranial aneurysms by functional reconstruction of the parent artery: the Budapest experience with the pipeline embolization device. AJNR Am J Neuroradiol. 2010;31(6):1139\u20131147.20150304"},{"issue":"6","key":"b3","series-title":"J Clin Neurosci","first-page":"737","article-title":"Flow diverters for treatment of intracranial aneurysms: current status and ongoing clinical trials","volume":"18","author":"Wong GK","year":"2011","unstructured":"Wong GK, Kwan MC, Ng RY, Yu SC, Poon WS. Flow diverters for treatment of intracranial aneurysms: current status and ongoing clinical trials. J Clin Neurosci. 2011;18(6):737\u2013740.21514166"},{"issue":"8","key":"b4","series-title":"Stroke","first-page":"2346","article-title":"A new endoluminal, flow-disrupting device for treatment of saccular aneurysms","volume":"38","author":"Kallmes DF","year":"2007","unstructured":"Kallmes DF, Ding YH, Dai D, Kadirvel R, Lewis DA, Cloft HJ. A new endoluminal, flow-disrupting device for treatment of saccular aneurysms. Stroke. 2007;38(8):2346\u20132352.17615366"},{"issue":"2","key":"b5","series-title":"AJNR Am J Neuroradiol","first-page":"295","article-title":"Endothelialization following flow diversion for intracranial aneurysms: a systematic review","volume":"40","author":"Ravindran K","year":"2019","unstructured":"Ravindran K, Salem MM, Alturki AY, Thomas AJ, Ogilvy CS, Moore JM. Endothelialization following flow diversion for intracranial aneurysms: a systematic review. 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Actual metal coverage at the neck is critical for flow-diverting stents in treating intracranial aneurysms. AJNR Am J Neuroradiol. 2013;34(3):E31\u2013E32.23449658"},{"issue":"6","key":"b26","series-title":"J Neurosurg","first-page":"1258","article-title":"Panacea or problem: flow diverters in the treatment of symptomatic large or giant fusiform vertebrobasilar aneurysms","volume":"116","author":"Siddiqui AH","year":"2012","unstructured":"Siddiqui AH, Abla AA, Kan P,  Panacea or problem: flow diverters in the treatment of symptomatic large or giant fusiform vertebrobasilar aneurysms. 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