Dr. Philip Meyers from our Cerebrovascular and Endovascular Centers has made history here at Columbia as the first to use the new Pipeline™ Embolization Device for the treatment of brain aneurysms.

Approved by the Food and Drug Administration last April, the Pipeline Device had previously been used solely in clinical trials.

Dr. Meyers says, “We performed our first cases six to eight weeks ago and everybody is doing well. The treatment has been very effective for these patients and their aneurysms.”

An aneurysm occurs when a weakened area within a blood vessel wall balloons outward. They are dangerous, primarily because they can burst and cause a fatal brain bleed. Giant aneurysms, as in the images above, can also lead to an ischemic (non-hemorrhagic) stroke as it is prone to blood clot formation. A portion of that clot can then break free and lodge in a brain artery. In many cases, however, giant aneurysms become symptomatic by pressing on surrounding nerves and brain structures.

The key to treatment is to take pressure off of the aneurysm, this is usually done in one of two ways; clipping or coiling. Clipping is an open brain procedure where a small clip is placed at the base of the aneurysm to cut off its blood supply. Coiling is a minimally invasive technique within the blood vessel where tiny coils are used to fill the aneurysm to give it structure and keep it from bursting.

Philip Meyers, MD

The Pipeline Device is an all-together different approach. According to Meyers, “It is the first time that someone has applied a device that is specificlaly meant to remodel the blood vessel without actually treating the aneurysm seperately.”

A tiny mesh tube made of braided wire is placed within the blood vessel adjacent to the aneurysm.  There, it reinforces the vessel walls and takes pressure off of the aneurysm. Because of its mesh construction, circulation of blood within the aneurysm stops, then the aneurysm heals and disappears.

The images (red arrows in figure set above left) show a large aneurysm before and after treatment with the Pipeline Device. Notice in the bottom right image, blood flow to the aneurysm has completely stopped thus excluding it from the brain circulation so the vessel can heal.

Dr. Meyers says he is pleased with the results and is likely to continue to use the Pipeline device.

Watch this Pipline animation created by ev3, the maker of the device, to better understand how it works.

You can also learn more about the treatment of aneurysms in our previous blogs:
Get This Thing Out Of My Head!
Solomon Heads Giant Aneurysms Off At The Pass
Results From First IML: Aneurysm Coiling V. Clipping Still A Toss Up
Endovascular Neuroradiology; The New Frontier