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Delayed neurological deficits after endovascular placement of a pipeline embolisation device: clinical manifestation and treatment
  1. Naveen Sablani,
  2. Maryam Mumtaz Hasan,
  3. Ashik Shrestha,
  4. Jeffrey Farkas
  1. Department Of Medicine, NYU Langone Hospital, Brooklyn, New York, USA
  1. Correspondence to Dr Naveen Sablani, nsablani{at}


Endovascular treatment has been the mainstay of therapy for repair of both ruptured and unruptured cerebral aneurysms. Flow diverter devices offer a new option for the treatment of complex aneurysms that were previously not amenable to coiling. Procedural adverse effects include intracranial haemorrhage and ischaemic stroke, which usually occur on the same day. Delayed complications are rare. We report a case of a patient who underwent placement of a pipeline embolisation device and developed delayed neurological deficits, which were thought to be an inflammatory reaction to the hydrophilic coating used in guidewires and microcatheters. Our patient was treated with a course of steroids, with improvement of her neurological deficits and resolution of MRI findings. As the use of flow diverter devices has increased, variable and delayed complications of such therapy are increasingly being reported in the literature.

  • neurology (drugs and medicines)
  • neuroimaging
  • interventional radiology

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  • Contributors NS: primarily involved in creating the initial draft, design and reviewing the literature. MMH: predominantly helped in looking up the EMR for relevant information about the patient, acquisition of data and planning. AS: contributed mainly towards revision, adding relevant images, proper organisation and finishing the paper. JF: reviewed the paper, gave feedback, and helped analyse the data and understand the concept. All authors contributed substantially and approved the final draft.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.