PURPOSE: The pipeline embolization device (PED) is a flow diverter that has shown promise in the treatment of @entity438 . Close to one-fifth of @entity439 , however, fail to occlude after PED placement. This study aims to identify anatomical features and clinicopathologic factors that may predispose failed @entity439 with the PED. MATERIALS AND METHODS: We retrospectively reviewed all anterior circulation @entity439 treated with the PED in a single-center. The primary outcome measure was angiographic occlusion. Anatomical features and potential predictors, including gender, @entity439 location, size, height, aspect ratio, neck width, prior treatment and the number of PED, were studied using binary logistic regression. RESULTS: 29 anterior circulation @entity439 with a mean size of 6.99 mm treated with the PED in a single center were retrospectively studied. The overall occlusion rate was 79.3% after a mean follow-up of 9.2 months. Four @entity439 were related to the fetal-type posterior communicating artery (PComA), and all were refractory to flow diverter treatment. Female gender was significantly associated with a higher occlusion rate. We present the anatomical features and propose possible pathophysiological mechanisms of these PComA @entity439 that failed flow diverter treatment. CONCLUSION: A PComA @entity439 with persistent fetal-type circulation appears to be particularly refractory to flow diverter treatment, especially when the @entity439 incorporates a significant portion of the PComA. Our experience suggested that flow diverting stents alone may not be the ideal treatment for this subgroup of @entity439 , and alternative modalities should be considered. Female @entity1 were found to have a significantly higher rate of treatment success.

Failure of Flow Diverter Treatment of XXXX Related to the Fetal-type Posterior Communicating Artery.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity439 :: ('MESH:D000783', 'Disease') :: ['aneurysms', 'unruptured saccular aneurysms', 'aneurysm', 'aneurysm occlusion'] @entity438 :: ('MESH:D002532', 'Disease') :: ['intracranial aneurysms']
@entity438 :: (MESH:D002532,Disease) :: ['Intracranial Aneurysms']
