• Shields Lisa B E LBE Norton Neuroscience Institute, Norton Healthcare, Louisville, Kentucky, USA., Christopher B Shields, Mayshan Ghiassi, Shervin R Dashti, Tom L Yao, Yi Ping Zhang, and Mahan Ghiassi.
• Norton Neuroscience Institute, Norton Healthcare, Louisville, Kentucky, USA.
• World Neurosurg. 2019 Dec 1; 132: 106-112.

BackgroundDissecting pseudoaneurysms of the craniocervical circulation are uncommon, accounting for only 3% of all cerebral aneurysms. These aneurysms pose a challenge due to their location and anatomic configuration. The Pipeline Embolization Device (PED) is a flow diversion technique that successfully treats aneurysms by diverting blood flow away from the aneurysm and reconstructing the diseased parent artery by altering its hemodynamics.Case DescriptionWe report 3 cases in which the PED was used to treat craniocervical carotid artery dissection with associated pseudoaneurysms. A single PED was used in the first case, 4 PEDs were used in the second case, and 3 PEDs and a PRECISE PRO RX carotid stent were placed in the third case. All 3 patients achieved full neurologic recovery postoperatively. Cerebral angiography performed postoperatively demonstrated revascularization, good laminar flow, and no in-stent or adjacent stenosis.ConclusionsPED placement offers a safe and effective method of treating spontaneous or traumatic craniocervical carotid artery dissections with excellent neurologic outcomes postoperatively and complete long-term aneurysmal occlusion.Copyright © 2019 Elsevier Inc. All rights reserved.

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