RT Journal Article SR Electronic T1 Spontaneous Delayed Migration/Shortening of the Pipeline Embolization Device: Report of 5 Cases JF American Journal of Neuroradiology JO Am. J. Neuroradiol. FD American Society of Neuroradiology SP 2326 OP 2330 DO 10.3174/ajnr.A3632 VO 34 IS 12 A1 Chalouhi, N. A1 Tjoumakaris, S.I. A1 Gonzalez, L.F. A1 Hasan, D. A1 Pema, P.J. A1 Gould, G. A1 Rosenwasser, R.H. A1 Jabbour, P.M. YR 2013 UL http://www.ajnr.org/content/34/12/2326.abstract AB SUMMARY: Five patients were found to have spontaneous delayed migration/shortening of their Pipeline Embolization Devices on follow-up angiography. The device migrated proximally in 4 patients and distally in 1 patient. One patient had a subarachnoid hemorrhage and died as a result of migration of the Pipeline Embolization Device, and another patient presented with complete MCA occlusion and was left severely disabled. Mismatch in arterial diameter between inflow and outflow vessels was a constant finding. Migration of the Pipeline Embolization Device was managed conservatively, with additional placement of the device, or with parent vessel occlusion. Obtaining complete expansion of the embolization device by using a longer device, increasing vessel coverage, using adjunctive aneurysm coiling, and avoiding dragging and stretching of the device are important preventive measures. Neurointerventionalists should be aware of this potentially fatal complication and take all necessary preventive measures. PEDPipeline Embolization DeviceSHAsuperior hypophyseal artery