Aneurysm treatment with the Pipeline Vantage Embolization Device in Retrospective Evaluation: Periprocedural results from the Pipe-VADER study

The Pipeline Vantage Embolization Device is a fourth-generation flow diverter with an antithrombotic coating and a reduced profile compared to previous Pipeline versions. The objective of this study was to evaluate the procedural feasibility, safety and efficacy of this device.The Pipe-VADER study was designed as a retrospective, observational study of consecutive patients treated with the Vantage at three neurovascular centers. Patient and aneurysm characteristics, procedural parameters, early complications, and extent of postinterventional contrast retention were analyzed on an intention-to-treat basis.Twenty-eight patients with 31 aneurysms (median size: 5.0 mm, posterior circulation: 12.9%, ruptured: 16.1%) were included. The technical success rate was 100%, with multiple stents used in 4/30 (13.3%) procedures. Adjunctive coiling was performed in 10.0% and balloon angioplasty in 6.7%. Median procedure time was 62 minutes. The overall symptomatic complication rate was 16.7%, including 4 (13.3%) ischemic strokes, of which 2 (6.6%) were classified as major strokes. There were no hemorrhagic complications. Initial contrast retention was observed in 29/31 (93.5%) aneurysms. All 27 overstented side vessels were patent at the end of the procedure. Five-month follow-up showed complete and favorable occlusion rates of 70% and 80%, respectively.The new Pipeline Vantage appears to be safe and feasible for the treatment of intracranial aneurysms and warrants further evaluation.