CLINICAL EVIDENCE – FLOW DIVERSION BRAIN ANEURYSM THERAPIES

PREMIER TRIAL

Close-up view of Pipeline Flex embolization device

PREMIER (PRospective study on EMbolization of Intracranial anEuRysms with the Pipeline™ device) was a multi-center, prospective, interventional, single-arm trial to evaluate the safety and effectiveness of the Pipeline device* in the treatment of unruptured wide-neck intracranial aneurysms, measuring ≤ 12 mm, located in the internal carotid artery (up to the terminus) or the vertebral artery segment up to and including the posterior inferior cerebellar artery in 141 subjects.

Results from the PREMIER Trial: 2.2% primary safety endpoint, 76.7% primary efficacy endpoint, 1.1 average number of devices implanted

PREMIER RESULTS1

Primary Safety Endpoint: Occurrence of major stroke in the territory supplied by the treated artery or neurological death at 1-year post-procedure.

Primary Efficacy Endpoint: Complete aneurysm occlusion (defined as Raymond-Roy grade 1) without significant parent artery stenosis (≤ 50%) or retreatment of the target aneurysm at 1-year post-procedure.

CONCLUSIONS

The PREMIER study is the first prospective, multicenter trial to evaluate the use of the Pipeline™ Flex* device for the treatment of small and medium, unruptured aneurysms of the intracranial carotid and proximal vertebral arteries. The findings from the PREMIER study provide evidence that treatment of wide-necked, small and medium intracranial aneurysms measuring ≤ 12 mm located in the ICA (up to the terminus) and proximal vertebral artery segment up to and including the posterior inferior cerebellar artery treated with the Pipeline™ device results in:

  • 95.9% attempted device success rate
  • 76.7% complete occlusion without significant parent artery stenosis or retreatment
  • 2.2% major stroke or neurological death
  • 2.9% retreatment
  • zero aneurysm recurrences at 1-year post-procedure

 

PUFs trial

PUFs (Pipeline Embolization Device for Uncoilable or Failed Aneurysms) was a multicenter, prospective, interventional, single-arm trial to evaluate the safety and effectiveness of the Pipeline implant† in the treatment of complex intracranial aneurysms.

PUFs studied 108 subjects with a wide-necked, large, or giant intracranial aneurysm in the petrous, cavernous, or paraophthalmic regions of the internal carotid artery.

  • For treatment success, target aneurysm had to be 100% occluded.
  • PUFs included a cohort of aneurysms that were challenging to treat, including giant and fusiform aneurysms (18.2 mm average size).

PUFS 5-YEAR RESULTS2

Results from the PUFs Trial after 5 years: 0% recurrence of aneurysms after complete occlusion, 95% occlusion at 5 years follow-up

CONCLUSION

Treatment of large and giant aneurysms in the internal carotid artery (ICA) with the Pipeline device is safe and effective.

PUFs Efficacy and Safety Outcomes
*

The PREMIER study included the Pipeline Embolization Device and Pipeline Flex Embolization Device. The Pipeline Flex Embolization Device contains the same implant as the Pipeline Embolization Device.

†

The PUFs study only included the Pipeline embolization device. The Pipeline Flex embolization device contains the same implant as the Pipeline embolization device.

Results may vary. Not all patients receive the same results.

1

PREMIER Clinical Study Report Medtronic FD3563 Rev B. 12-SEP-2018.

2

Becske T. et al., Five-Year Results of the Pipeline for Uncoilable or Failed Aneurysms Trial. Neurosurgery (JNS). Published online Jan. 06, 2017.