{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T04:52:02Z","timestamp":1770353522300,"version":"3.49.0"},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"12","license":[{"start":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T00:00:00Z","timestamp":1694995200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,18]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Flow diversion, specifically with the Pipeline embolization device (PED), represents a paradigm shift in the treatment of intracranial aneurysms. Several studies have demonstrated its efficacy and at times superiority to conventional treatment modalities for aneurysms with a fusiform morphology, giant size, or wide neck. However, there may be a nonsignificant risk of recurrence after flow diversion of these historically difficult-to-treat aneurysms, relative to aneurysms with a more favorable morphology and size (i.e., saccular, narrow necked). To date, only three papers in the literature have demonstrated the recurrence of a completely occluded aneurysm on follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>The authors describe a patient with a giant middle cerebral artery fusiform aneurysm treated with multiple telescoping PEDs. On the 3-month follow-up angiogram, there was complete occlusion of the aneurysm. The patient was lost to follow-up and presented 4 years later with a recurrence of the aneurysm between PED segments, requiring retreatment. The patient represented 3 years posttreatment with the need for repeat treatment of the fusiform aneurysm due to separation of the existing PEDs along with stent reconstruction. At the 20-month follow-up after the third treatment, the initial aneurysm target was found to be occluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>This case illustrates the need for long-term follow-up, specifically for patients with giant wide-necked or fusiform aneurysms treated with overlapping PEDs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case23369","type":"journal-article","created":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T21:15:52Z","timestamp":1695071752000},"source":"Crossref","is-referenced-by-count":0,"title":["Recurrence of a large intracranial fusiform aneurysm treated with overlapping Pipeline embolization devices: illustrative case"],"prefix":"10.3171","volume":"6","author":[{"given":"Jeyan Sathia","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nisha","family":"Dabhi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel M. S","family":"Raper","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Baylor College of Medicine, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stepan","family":"Capek","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. Webster","family":"Crowley","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Rush University, Chicago, Illinois; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Yashar","family":"Kalani","sequence":"additional","affiliation":[{"name":"Ascension Medical Group, Tulsa, Oklahoma"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan T","family":"Kellogg","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min S","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"8","key":"b1","series-title":"Stroke","first-page":"2363","article-title":"Flow diversion for intracranial aneurysms: a review","volume":"42","author":"D\u2019Urso PI","year":"2011","unstructured":"D\u2019Urso PI, Lanzino G, Cloft HJ, Kallmes DF. Flow diversion for intracranial aneurysms: a review. Stroke. 2011;42(8):2363\u20132368."},{"key":"b2","series-title":"Stroke Res Treat","first-page":"415653","article-title":"Flow diverters for intracranial aneurysms","volume":"2014","author":"Alderazi YJ","year":"2014","unstructured":"Alderazi YJ, Shastri D, Kass-Hout T, Prestigiacomo CJ, Gandhi CD. Flow diverters for intracranial aneurysms. Stroke Res Treat. 2014;2014:415653."},{"issue":"3","key":"b3","series-title":"Neurosurg Rev","first-page":"1471","article-title":"Flow diversion of fusiform intracranial aneurysms","volume":"44","author":"Griffin A","year":"2021","unstructured":"Griffin A, Lerner E, Zuchowski A, Zomorodi A, Gonzalez LF, Hauck EF. Flow diversion of fusiform intracranial aneurysms. Neurosurg Rev. 2021;44(3):1471\u20131478."},{"key":"b4","series-title":"World Neurosurg","first-page":"7","article-title":"Multiple telescoping flow diverter technique in endovascular treatment of a giant petrous and cavernous carotid aneurysm","volume":"167","author":"Sun L","year":"2022","unstructured":"Sun L, Ren J, Ye M, Zhang H. Multiple telescoping flow diverter technique in endovascular treatment of a giant petrous and cavernous carotid aneurysm. World Neurosurg. 2022;167:7."},{"issue":"6","key":"b5","series-title":"Neurosurg Focus","first-page":"E16","article-title":"Prolapse of the Pipeline embolization device in aneurysms: incidence, management, and outcomes","volume":"42","author":"Srinivasan VM","year":"2017","unstructured":"Srinivasan VM, Carlson AP, Mokin M,  Prolapse of the Pipeline embolization device in aneurysms: incidence, management, and outcomes. Neurosurg Focus. 2017;42(6):E16."},{"issue":"2","key":"b6","series-title":"Interv Neuroradiol","first-page":"182","article-title":"Very delayed discontinuation of telescoped Pipeline embolization devices: a case report","volume":"25","author":"Bohara M","year":"2019","unstructured":"Bohara M, Teranishi K, Yatomi K,  Very delayed discontinuation of telescoped Pipeline embolization devices: a case report. Interv Neuroradiol. 2019;25(2):182\u2013186."},{"issue":"7","key":"b7","series-title":"J Neurosurg Case Lessons","first-page":"CASE22497","article-title":"A challenging case of recurrent and progressive fusiform anterior circulation intracranial aneurysms: illustrative case","volume":"5","author":"Coxon AT","year":"2023","unstructured":"Coxon AT, Huguenard AL, Chatterjee AR, Dacey RG. A challenging case of recurrent and progressive fusiform anterior circulation intracranial aneurysms: illustrative case. J Neurosurg Case Lessons. 2023;5(7):CASE22497."},{"issue":"1","key":"b8","series-title":"J Neurosci Rural Pract","first-page":"142","article-title":"Regrowth of a large intracranial aneurysm after on-label use of the Pipeline embolization device","volume":"10","author":"Chen CJ","year":"2019","unstructured":"Chen CJ, Patibandla MR, Park MS, Kalani MY. Regrowth of a large intracranial aneurysm after on-label use of the Pipeline embolization device. J Neurosci Rural Pract. 2019;10(1):142\u2013144."},{"issue":"8","key":"b9","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,  Comparison of flow diversion and coiling in large unruptured intracranial saccular aneurysms. Stroke. 2013;44(8):2150\u20132154."},{"issue":"1","key":"b10","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. 2011;32(1):34\u201340."},{"issue":"9","key":"b11","series-title":"Acta Neurochir (Wien)","first-page":"1153","article-title":"Symptomatic enlargement of an occluded giant carotido-ophthalmic aneurysm after endovascular treatment: the vasa vasorum theory","volume":"151","author":"Dehdashti AR","year":"2009","unstructured":"Dehdashti AR, Thines L, Willinsky RA, Tymianski M. Symptomatic enlargement of an occluded giant carotido-ophthalmic aneurysm after endovascular treatment: the vasa vasorum theory. 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World Neurosurg. 2022;167:7."},{"issue":"6","key":"b5","series-title":"Neurosurg Focus","first-page":"E16","article-title":"Prolapse of the Pipeline embolization device in aneurysms: incidence, management, and outcomes","volume":"42","author":"Srinivasan VM","year":"2017","unstructured":"Srinivasan VM, Carlson AP, Mokin M,  Prolapse of the Pipeline embolization device in aneurysms: incidence, management, and outcomes. Neurosurg Focus. 2017;42(6):E16."},{"issue":"2","key":"b6","series-title":"Interv Neuroradiol","first-page":"182","article-title":"Very delayed discontinuation of telescoped Pipeline embolization devices: a case report","volume":"25","author":"Bohara M","year":"2019","unstructured":"Bohara M, Teranishi K, Yatomi K,  Very delayed discontinuation of telescoped Pipeline embolization devices: a case report. 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AJNR Am J Neuroradiol. 2011;32(1):34\u201340."},{"issue":"9","key":"b11","series-title":"Acta Neurochir (Wien)","first-page":"1153","article-title":"Symptomatic enlargement of an occluded giant carotido-ophthalmic aneurysm after endovascular treatment: the vasa vasorum theory","volume":"151","author":"Dehdashti AR","year":"2009","unstructured":"Dehdashti AR, Thines L, Willinsky RA, Tymianski M. Symptomatic enlargement of an occluded giant carotido-ophthalmic aneurysm after endovascular treatment: the vasa vasorum theory. Acta Neurochir (Wien). 2009;151(9):1153\u20131158."},{"issue":"9","key":"b12","series-title":"AJNR Am J Neuroradiol","first-page":"1716","article-title":"Evolution of flow-diverter endothelialization and thrombus organization in giant fusiform aneurysms after flow diversion: a histopathologic study","volume":"36","author":"Szikora I","year":"2015","unstructured":"Szikora I, Tur\u00e1nyi E, Marosfoi M. 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AJNR Am J Neuroradiol. 2011;32(11):2175\u20132179."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/6\/12\/article-CASE23369.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/6\/12\/article-CASE23369.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/6\/12\/article-CASE23369.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T14:32:18Z","timestamp":1770301938000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/6\/12\/article-CASE23369.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,18]]},"references-count":26,"journal-issue":{"issue":"12"},"URL":"https:\/\/doi.org\/10.3171\/case23369","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,18]]}}}