1191 – Endovascular treatment of intracranial aneurysms-Pipeline Embolization Device (PED)

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Interventional flow diversion and reconstruction of an artery using a flexible scaffolding prosthesis (pipeline or other prosthesis approved for the same indication by the TGA) across an intracranial aneurysm neck.

An intracranial aneurysm, also known as a cerebral or brain aneurysm, is an abnormal, localised dilation that balloons or bulges from an artery that supplies blood to the brain. They are commonly defined by their size, shape and location:

1. Unruptured intracranial aneurysms can be symptomatic or asymptomatic. They do not constitute a surgical emergency. However, unruptured intracranial aneurysms that are not treated present a high morbidity and mortality risk.
2. A large unruptured aneurysm constricting local nerves can cause blindness, paralysis or other major neurological syndromes. In relation to intracranial aneurysms, these syndromes are known as “mass effect”. Without treatment, the “mass effect” becomes worse.
3. An unruptured aneurysm larger than 5mm has a 2 to 4 % actuarial risk of hemorrhage, representing a considerable risk for young people.

Endovascular embolization of intracranial aneurysms is intended for complex intracranial aneurysms, specifically, those that are large (10 – 25mm in diameter) or giant (>25mm in diameter). Large or giant intracranial aneurysms can be saccular, where they are usually wide necked (>4 mm), or fusiform in shape (i.e. they have no discernible necks).