Pipeline

Hi,

Just curious. Is there a difference between a pipeline stent and a pipeline embolization device or are they same thing - just different terminology? Why do they not use coils when using the pipeline? Is that a rule of thumb or it depends on the annie? Appreciate any info.

Hi Cris,

The Pipeline embolization device is the PED and the pipeline stent. Same device, different names for it!

The pipeline was created for complicated wide mouth annies that develop in the internal carotid artery. It has become such a wonderful tool that it is now being used off label and outside the ICA. We have two or three in our PED group that have had basilar annies that have been given the PED.

Coils cannot hold in a wide mouth annie, and there have been some who have had both. I'm not sure of the reasons why a doctor would use coils and the stent, but my attempted coiling failed, and I went back 10 days later for the PED. My surgeon indicated that the annie that I had, a 9mm ICA annie right at the ophthalmic artery, was not able to be clipped due to it being so close to the optic nerve that a clip would have blinded me. I'm sure there are many different factors taken into account when the doctor gives options on coiling, or coiling with a stent like the PED.

I hope this helps and hopefully others will respond with their own thoughts or knowledge of the PED.

Linda

Thanks Linda. Until recently, I always believed I was coiled and stented. I got confused with the stenting. My neurosurgeon confirmed that in fact all I had was a pipeline stent. No coils - although initially this was the plan and that's why I thought this was what they did all along. I guess when they "went in" (jan 2011), they decided otherwise. Mine was a wide-necked 8.5 mm right paraopthalmic ICA annie. It all make sense now. Took me a while to put it together :)

Wow Linda , You sound just like me . I too have a 9mm annie behind my right eye and they couldn't clip it for the same reasons . I have 3 procedures ,1st was time of rupture I was given 9 coils but needed more but vessels began to spasm so they stopped . I went back 4 months later for more coils but woke to find they couldn't get them in so he put in a stent in hopes that would help . Went back 8 months later and woke with nothing new , my annie is next to a bend in artery and is difficult that and he said I have dainty vessels which makes it a bit more difficult . I go back again In may for a pipeline stent . so my question is whats the difference between the stent I already have and a pipeline stent or are all stents considered pipeline ? So confusing

Amanda C.

Amanda,
We’re twins! lol
I think that’s actually a good question to ask your surgeon on your next visit.
I do know that the intention of the pipeline stent is to divert the flow of blood away from the aneurysm and that it was not originally intended to be used with coils, but as a standalone device. Also, somewhere on the BAF website there is a breakdown of the different types of surgeries used in the treatment of brain aneurysms, which I believe includes information on both the pipeline stent and the stent assisted coiling.
When you do find out, please post it because you have piqued my interest!
Good luck on your upcoming surgery, and please let us know how you make out. Best wishes,
Linda

Hi Cris, I had both coils and pipeline. My annie was large so the coils were not staying in so they also used the pipeline. They can use both or just one. I think it depends on the aneurysm, where it is and size. Deb