Griauzde, j., ravindra, v.M., chaudhary, n., gemmete, j.J., mazur, m.D., roark, c.D.,.Pandey, a.S.(2017).Use of the pipeline embolization device in the treatment of iatrogenic intracranial vascular injuries: a bi-institutional experience.Neurosurgical focus, 42(6).Doi:10.3171/2017.3.Focus1735 the pipeline device has not been returned for evaluation as it remains implanted in the patient; product analysis cannot be performed.The report of suboptimal wall apposition cannot be performed; the cause of suboptimal wall apposition cannot be conclusively determined from the reported information.It should be noted that the pipeline device is not indicated for use in the treatment of vessel dissections.Per the instructions for use, "the ped is intended for endovascular embolization of cerebral aneurysms." a good faith effort will be made to obtain the applicable information relevant to the report.If information is provided in the future, a supplemental report will be issued.
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Medtronic literature review found a report of suboptimal wall apposition after pipeline placement.The purpose of this article was to report the experience with the use of the pipeline embolization device (ped) for the treatment of iatrogenic intracranial vascular injuries.The article states that in case 3, the patient was undergoing resection of a recurrent pituitary macroadenoma.After resection, brisk bleeding was encountered from the right internal carotid artery (ica).Cerebral angiography demonstrated disintegration of the right ica at the distal cavernous segment proximal to the anterior genu with contrast extravasation and injury to the intima with narrowing and dissection of the vessel.A ped was placed proximal to the ophthalmic artery to the distal petrous segment.The article states that there was suboptimal wall apposition and continued extravasation from the segment, likely because of the nature and size of the vessel injury.The vessel was sacrificed using coil embolization, trapping the injured segment with coils from proximal to the ophthalmic artery to the distal petrous segment.
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