Neuroophthalmological Outcomes Associated With Use of the Pipeline Embolization Device: Analysis of the PUFS Trial Results
Department
neurosurgery
Document Type
Article
Abstract
Object Neuroophthalmological morbidity is commonly associated with large and giant cavernous and supraclinoid internal carotid artery (ICA) aneurysms. The authors sought to evaluate the neuroophthalmological outcomes after treatment of these aneurysms with the Pipeline Embolization Device (PED). Methods The Pipeline for Uncoilable or Failed Aneurysms (PUFS) trial was an international, multicenter prospective trial evaluating the safety and efficacy of the PED. All patients underwent complete neuroophthalmological examinations both before the PED procedure and at a 6-month follow-up. All examinations were performed for the purpose of this study and according to study criteria. Results In total, 108 patients were treated in the PUFS trial, 98 of whom had complete neuroophthalmological follow-up. Of the patients with complete follow-up, 39 (40%) presented with a neuroophthalmological baseline deficit that was presumed to be attributable to the aneurysm, and patients with these baseline deficits had significantly larger aneurysms. In 25 of these patients (64%), the baseline deficit showed at least some improvement 6 months after PED treatment, whereas in 1 patient (2.6%), the deficits only worsened. In 5 patients (5%), new deficits had developed at the 6-month follow-up, while in another 6 patients (6%), deficits that were not originally assumed to be related to the aneurysm had improved by that time. A history of diabetes was associated with failure of the baseline deficits to improve after the treatment. The aneurysm maximum diameter was significantly larger in patients with a new deficit or a worse baseline deficit at 6 months postprocedure. Conclusions Patients treated with the PED for large and giant ICA aneurysms had excellent neuroophthalmological outcomes 6 months after the procedure, with deficits improving in most of the patients, very few deficits worsening, and few new deficits developing.
Publication Date
2015
Publication Title
Journal of Neurosurgery
ISSN
0022-3085
Volume
123
Issue
4
First Page
897
Last Page
905
Digital Object Identifier (DOI)
10.3171/2014.12.JNS141777
Recommended Citation
Sahlein, Daniel H.; Fouladvand, Mohammad; Becske, Tibor; Saatci, Isil; McDougall, Cameron G.; Szikora, Istvan; Lanzino, Giuseppe; Moran, Christopher J.; Woo, Henry H.; Lopes, Demetrius K.; Berez, Aaron L.; Cher, Daniel J.; Siddiqui, Adnan H.; Levy, Elad I.; Albuquerque, Felipe C.; Fiorella, David J.; Berentei, Zsolt; Marosfoi, Miklos; Cekirge, Saruhan H.; Kallmes, David F.; and Nelson, Peter K., "Neuroophthalmological Outcomes Associated With Use of the Pipeline Embolization Device: Analysis of the PUFS Trial Results" (2015). Neurosurgery. 287.
https://scholar.barrowneuro.org/neurosurgery/287