• Felipe Padovani Trivelato, Eduardo Wajnberg, Rezende Marco Túlio Salles MTS Division of Interventional Neuroradiology, Felício Rocho Hospital, Belo Horizonte, Brazil., Alexandre Cordeiro Ulhôa, Ronie Leo Piske, Thiago Giansante Abud, Luís Henrique de Castro-Afonso, Carlos Gustavo Coutinho Abath, Guilherme Seizem Nakiri, Araújo João Francisco Santoro JFS Division of Interventional Neuroradiology, Americas Medical Services, Rio de Janeiro, Brazil., José Laércio Júnior Silva, Renato Tavares Tosello, José Ricardo Vanzin, Luciano Bambini Manzato, Carlos Eduardo Baccin, Bruno Anderson Araújo da Mota, and Daniel Giansante Abud.
• Division of Interventional Neuroradiology, Felício Rocho Hospital, Belo Horizonte, Brazil.
• Neurosurgery. 2020 Jul 1; 87 (1): 104-111.

BackgroundThe safety and efficacy of the first generation of the Pipeline Embolization Device (PED; Medtronic Inc) have been proven in large case series. Ischemic events are one of the most common complications following treatment of aneurysms with flow diverters. The new PED Flex with Shield technology (PED Shield; Medtronic Inc) was introduced to minimize the rate of complications.ObjectiveTo evaluate the outcomes of patients harboring aneurysms treated with the PED Shield.MethodsThis was an observational, prospective, single-arm multicenter study of patients treated with the PED Shield. The primary safety endpoint was the absence of major neurological complications and death. The secondary effectiveness endpoint was angiographic occlusion at 6 and 12 mo. Technical complications were also reported.ResultsBetween November 2017 and December 2018, 151 patients from 7 centers with 182 aneurysms were enrolled. The mean aneurysm size was 7.0 mm; 27 (14.8%) aneurysms were large, and 7 (3.8%) were giant. In 141 of 151 patients (93.4%), the primary endpoint was reached. The overall rate of periprocedural complications was 7.3%. Of the aneurysms, 79.7% met the study's secondary endpoint of complete occlusion at 6 mo and 85.3% at 12 mo.ConclusionThe PED Shield is a safe and effective treatment for intracranial aneurysms. The results regarding total occlusion and ischemic complications did not differ from those obtained in case series using previous versions of the PED. Long-term follow-up and comparative studies are required to provide stronger conclusions regarding the reduced thrombogenicity of this device.Copyright © 2019 by the Congress of Neurological Surgeons.

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