Histopathological assessment of fatal ipsilateral intraparenchymal hemorrhages after the treatment of supraclinoid aneurysms with the Pipeline Embolization Device

Yin C. Hu, Vivek R. Deshmukh, Felipe C. Albuquerque, David Fiorella, Randal R. Nixon, Donald V. Heck, Stanley L. Barnwell, Cameron G. McDougall

Research output: Contribution to journalArticle

67 Citations (Scopus)

Abstract

Object. Delayed ipsilateral intraparenchymal hemorrhage has been observed following aneurysm treatment with the Pipeline Embolization Device (PED). The relationship of this phenomenon to the device and/or procedure remains unclear. The authors present the results of histopathological analyses of the brain sections from 3 patients in whom fatal ipsilateral intracerebral hemorrhages developed several days after uneventful PED treatment of supraclinoid aneurysms. Methods. Microscopic analyses revealed foreign material occluding small vessels within the hemorrhagic area in all patients. Further analyses of the embolic materials using Fourier transform infrared (FTIR) spectroscopy was conducted on specimens from 2 of the 3 patients. Although microscopically identical, the quantity of material recovered from the third patient was insufficient for FTIR spectroscopy. Results. FTIR spectroscopy showed that the foreign material was polyvinylpyrrolidone (PVP), a substance that is commonly used in the coatings of interventional devices. Conclusions. These findings are suggestive of a potential association between intraprocedural foreign body emboli and post-PED treatment-delayed ipsilateral intraparenchymal hemorrhage.

Original languageEnglish (US)
Pages (from-to)365-374
Number of pages10
JournalJournal of Neurosurgery
Volume120
Issue number2
DOIs
StatePublished - Feb 2014

Fingerprint

Aneurysm
Hemorrhage
Fourier Transform Infrared Spectroscopy
Equipment and Supplies
Therapeutics
Povidone
Cerebral Hemorrhage
Foreign Bodies
Embolism
Brain

Keywords

  • Aneurysm
  • Hemorrhage
  • Pipeline embolization device
  • Vascular disorders

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Histopathological assessment of fatal ipsilateral intraparenchymal hemorrhages after the treatment of supraclinoid aneurysms with the Pipeline Embolization Device. / Hu, Yin C.; Deshmukh, Vivek R.; Albuquerque, Felipe C.; Fiorella, David; Nixon, Randal R.; Heck, Donald V.; Barnwell, Stanley L.; McDougall, Cameron G.

In: Journal of Neurosurgery, Vol. 120, No. 2, 02.2014, p. 365-374.

Research output: Contribution to journalArticle

Hu, Yin C. ; Deshmukh, Vivek R. ; Albuquerque, Felipe C. ; Fiorella, David ; Nixon, Randal R. ; Heck, Donald V. ; Barnwell, Stanley L. ; McDougall, Cameron G. / Histopathological assessment of fatal ipsilateral intraparenchymal hemorrhages after the treatment of supraclinoid aneurysms with the Pipeline Embolization Device. In: Journal of Neurosurgery. 2014 ; Vol. 120, No. 2. pp. 365-374.
@article{de8bca75a2744f798d54d15683826ea2,
title = "Histopathological assessment of fatal ipsilateral intraparenchymal hemorrhages after the treatment of supraclinoid aneurysms with the Pipeline Embolization Device",
abstract = "Object. Delayed ipsilateral intraparenchymal hemorrhage has been observed following aneurysm treatment with the Pipeline Embolization Device (PED). The relationship of this phenomenon to the device and/or procedure remains unclear. The authors present the results of histopathological analyses of the brain sections from 3 patients in whom fatal ipsilateral intracerebral hemorrhages developed several days after uneventful PED treatment of supraclinoid aneurysms. Methods. Microscopic analyses revealed foreign material occluding small vessels within the hemorrhagic area in all patients. Further analyses of the embolic materials using Fourier transform infrared (FTIR) spectroscopy was conducted on specimens from 2 of the 3 patients. Although microscopically identical, the quantity of material recovered from the third patient was insufficient for FTIR spectroscopy. Results. FTIR spectroscopy showed that the foreign material was polyvinylpyrrolidone (PVP), a substance that is commonly used in the coatings of interventional devices. Conclusions. These findings are suggestive of a potential association between intraprocedural foreign body emboli and post-PED treatment-delayed ipsilateral intraparenchymal hemorrhage.",
keywords = "Aneurysm, Hemorrhage, Pipeline embolization device, Vascular disorders",
author = "Hu, {Yin C.} and Deshmukh, {Vivek R.} and Albuquerque, {Felipe C.} and David Fiorella and Nixon, {Randal R.} and Heck, {Donald V.} and Barnwell, {Stanley L.} and McDougall, {Cameron G.}",
year = "2014",
month = "2",
doi = "10.3171/2013.11.JNS131599",
language = "English (US)",
volume = "120",
pages = "365--374",
journal = "Journal of Neurosurgery",
issn = "0022-3085",
publisher = "American Association of Neurological Surgeons",
number = "2",

}

TY - JOUR

T1 - Histopathological assessment of fatal ipsilateral intraparenchymal hemorrhages after the treatment of supraclinoid aneurysms with the Pipeline Embolization Device

AU - Hu, Yin C.

AU - Deshmukh, Vivek R.

AU - Albuquerque, Felipe C.

AU - Fiorella, David

AU - Nixon, Randal R.

AU - Heck, Donald V.

AU - Barnwell, Stanley L.

AU - McDougall, Cameron G.

PY - 2014/2

Y1 - 2014/2

N2 - Object. Delayed ipsilateral intraparenchymal hemorrhage has been observed following aneurysm treatment with the Pipeline Embolization Device (PED). The relationship of this phenomenon to the device and/or procedure remains unclear. The authors present the results of histopathological analyses of the brain sections from 3 patients in whom fatal ipsilateral intracerebral hemorrhages developed several days after uneventful PED treatment of supraclinoid aneurysms. Methods. Microscopic analyses revealed foreign material occluding small vessels within the hemorrhagic area in all patients. Further analyses of the embolic materials using Fourier transform infrared (FTIR) spectroscopy was conducted on specimens from 2 of the 3 patients. Although microscopically identical, the quantity of material recovered from the third patient was insufficient for FTIR spectroscopy. Results. FTIR spectroscopy showed that the foreign material was polyvinylpyrrolidone (PVP), a substance that is commonly used in the coatings of interventional devices. Conclusions. These findings are suggestive of a potential association between intraprocedural foreign body emboli and post-PED treatment-delayed ipsilateral intraparenchymal hemorrhage.

AB - Object. Delayed ipsilateral intraparenchymal hemorrhage has been observed following aneurysm treatment with the Pipeline Embolization Device (PED). The relationship of this phenomenon to the device and/or procedure remains unclear. The authors present the results of histopathological analyses of the brain sections from 3 patients in whom fatal ipsilateral intracerebral hemorrhages developed several days after uneventful PED treatment of supraclinoid aneurysms. Methods. Microscopic analyses revealed foreign material occluding small vessels within the hemorrhagic area in all patients. Further analyses of the embolic materials using Fourier transform infrared (FTIR) spectroscopy was conducted on specimens from 2 of the 3 patients. Although microscopically identical, the quantity of material recovered from the third patient was insufficient for FTIR spectroscopy. Results. FTIR spectroscopy showed that the foreign material was polyvinylpyrrolidone (PVP), a substance that is commonly used in the coatings of interventional devices. Conclusions. These findings are suggestive of a potential association between intraprocedural foreign body emboli and post-PED treatment-delayed ipsilateral intraparenchymal hemorrhage.

KW - Aneurysm

KW - Hemorrhage

KW - Pipeline embolization device

KW - Vascular disorders

UR - http://www.scopus.com/inward/record.url?scp=84893315719&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84893315719&partnerID=8YFLogxK

U2 - 10.3171/2013.11.JNS131599

DO - 10.3171/2013.11.JNS131599

M3 - Article

VL - 120

SP - 365

EP - 374

JO - Journal of Neurosurgery

JF - Journal of Neurosurgery

SN - 0022-3085

IS - 2

ER -