Fusiform aneurysms are less common than saccular aneurysms, but have higher associated mortality and rebleeding rates. Recently, flow diversion has emerged as a possible treatment option. The purpose of this study was to determine the safety and efficacy of the Pipeline Embolization Device (PED) for the treatment of ruptured and unruptured fusiform aneurysms. This was a retrospective analysis of patients with fusiform intracranial aneurysms treated with a PED at a quaternary care center between January 2012 and September 2019. Occlusion rates, neurologic morbidity/mortality, and other clinical variables were analyzed. Twenty-nine patients with 30 fusiform aneurysms were treated with a PED. Sixteen aneurysms (53%) were located in the anterior circulation and 14 aneurysms (47%) were in the posterior circulation. The mean maximal diameter of the aneurysms was 10.1 ± 5.6 mm (range 2.3–25 mm). Angiographic and clinical follow-up were available for 28 aneurysms (93%). The median follow-up was 17.4 months (IQR 4.8 to 28 months) and occlusion rates were graded according to the O’Kelly-Marotta (OKM) scale. Of patients with DSA follow-up, 15 aneurysms (60%) were completely occluded (OKM D) and 19 aneurysms (76%) had a favorable occlusion result (OKM C1-3 and D). The overall complication rate was 26.7% with a neurological morbidity rate of 6.7% and neurological mortality rate of 3.4%. Flow diversion can be an effective treatment for both ruptured and unruptured fusiform aneurysms. Nevertheless, complete occlusion rates are lower than for saccular aneurysms. Therefore, flow diversion should be considered only if other more direct treatment options, such as clipping or stent/coiling are not applicable. Flow diversion should be used cautiously in patients presenting with rupture.

梭状动脉瘤比囊状动脉瘤少见，但具有更高的相关死亡率和再出血率。近来，分流已成为一种可能的治疗选择。这项研究的目的是确定用于治疗破裂和未破裂的梭状动脉瘤的管道栓塞装置（PED）的安全性和有效性。这是对2012年1月至2019年9月间在四级护理中心接受PED治疗的梭形颅内动脉瘤患者的回顾性分析。分析了闭塞率，神经系统发病率/死亡率以及其他临床变量。PED治疗29例30梭状动脉瘤。前循环中有16个动脉瘤（53％），后循环中有14个动脉瘤（47％）。平均动脉瘤最大直径为10.1±5.6 mm（范围2.3–25 mm）。血管造影和临床随访可用于28个动脉瘤（93％）。中位随访时间为17.4个月（IQR 4.8至28个月），阻塞率根据O'Kelly-Marotta（OKM）量表进行分级。在进行DSA随访的患者中，有15例动脉瘤（60％）被完全阻塞（OKM D），有19例动脉瘤（76％）的阻塞结果良好（OKM C1-3和D）。总体并发症发生率为26.7％，神经系统发病率为6.7％，神经系统死亡率为3.4％。分流术对于破裂和未破裂的梭状动脉瘤都是有效的治疗方法。然而，完全阻塞的发生率低于囊状动脉瘤。因此，只有在其他更直接的处理方案中，才应考虑分流 例如修剪或支架/线圈不适用。出现破裂的患者应谨慎使用分流。