First US experience with Pipeline Flex with Shield Technology using aspirin as antiplatelet monotherapy

BMJ Case Rep. 2017 May 4:2017:bcr2017219406. doi: 10.1136/bcr-2017-219406.

Abstract

Flow diversion has revolutionised the treatment of intracranial aneurysms, and the Pipeline Embolization Device (PED) remains the only flow diverter (FD) approved in the USA. However, thromboembolic events remain an issue for FDs. Attempting to minimise these incidents, a newer PED has been developed with the use of covalent bonding of phosphorylcholine onto the Pipeline device that has been known as Shield Technology (PED Shield), which in vitro has demonstrated a significant reduction in material thrombogenicity. We report the first US experience of the PED Shield in the treatment of a ruptured fusiform aneurysm located in the right vertebral artery in an attempt to mitigate complications related to the use of dual-antiplatelet therapy and discuss our rationale for using the new FD, using aspirin only as the antiplatelet regimen.

Keywords: Interventional radiology; Neurosurgery; Stroke.

Publication types

  • Case Reports

MeSH terms

  • Aneurysm, Ruptured / complications*
  • Aneurysm, Ruptured / diagnostic imaging
  • Aneurysm, Ruptured / therapy
  • Angiography / methods
  • Aspirin / administration & dosage
  • Aspirin / therapeutic use*
  • Diffusion Magnetic Resonance Imaging / methods
  • Embolization, Therapeutic / adverse effects
  • Embolization, Therapeutic / instrumentation*
  • Endovascular Procedures / instrumentation*
  • Humans
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / therapy*
  • Male
  • Middle Aged
  • Phosphorylcholine / therapeutic use
  • Platelet Aggregation Inhibitors / administration & dosage
  • Platelet Aggregation Inhibitors / therapeutic use
  • Stents
  • Subarachnoid Hemorrhage / diagnostic imaging
  • Subarachnoid Hemorrhage / therapy*
  • Thromboembolism / complications
  • Thromboembolism / drug therapy
  • Thromboembolism / prevention & control
  • Treatment Outcome

Substances

  • Platelet Aggregation Inhibitors
  • Phosphorylcholine
  • Aspirin