Flow-diverting devices have been used successfully for the treatment of complex intracranial vascular injuries in adults, but the role of these devices in treating iatrogenic and traumatic intracranial vascular injuries in children remains unclear. The authors present their experience using the Pipeline embolization device (PED) for treating intracranial pseudoaneurysms in children.

This single-center retrospective cohort study included pediatric patients with traumatic and iatrogenic injuries to the intracranial vasculature that were treated with the PED between 2015 and 2021. Demographic data, indications for treatment, the number and sizes of PEDs used, follow-up imaging, and clinical outcomes were analyzed.

Six patients with a median age of 12 years (range 7–16 years) underwent PED placement to treat intracranial pseudoaneurysms. There were 3 patients with hemorrhagic presentation, 2 with ischemia, and 1 in whom a growing pseudoaneurysm was found on angiography. Injured vessels included the anterior cerebral artery (n = 2), the supraclinoid internal carotid artery (ICA, n = 2), the cavernous ICA (n = 1), and the distal cervical ICA (n = 1). All 6 pseudoaneurysms were successfully treated with PED deployment. One patient required re-treatment with a second PED within a week because of concern for a growing pseudoaneurysm. One patient experienced parent vessel occlusion without neurological sequelae.

Use of the PED is feasible for the management of iatrogenic and traumatic pseudoaneurysms of the intracranial vasculature in children, even in the setting of hemorrhagic presentation.

分流装置已成功用于治疗成人复杂的颅内血管损伤，但这些装置在治疗儿童医源性和外伤性颅内血管损伤中的作用仍不清楚。作者介绍了他们使用 Pipeline 栓塞装置 (PED) 治疗儿童颅内假性动脉瘤的经验。

这项单中心回顾性队列研究纳入了 2015 年至 2021 年间接受 PED 治疗的颅内血管创伤性和医源性损伤的儿科患者。人口统计数据、治疗指征、使用的 PED 数量和大小、随访影像学、并分析临床结果。

六名中位年龄为 12 岁（范围 7-16 岁）的患者接受了 PED 植入治疗颅内假性动脉瘤。 3 例患者出现出血，2 例出现缺血，1 例血管造影发现假性动脉瘤不断生长。受损血管包括大脑前动脉 (n = 2)、床突上颈内动脉 (ICA, n = 2)、海绵状 ICA (n = 1) 和远端颈内动脉 (n = 1)。所有 6 个假性动脉瘤均通过 PED 部署成功治疗。由于担心假性动脉瘤不断增大，一名患者需要在一周内接受第二次 PED 重新治疗。一名患者经历了载瘤血管闭塞，但没有出现神经系统后遗症。

使用 PED 治疗儿童颅内血管的医源性和外伤性假性动脉瘤是可行的，即使是在出血的情况下也是如此。