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Abstract Background The use of the pipeline embolization device (PED) with single or multiple coverage in cases of intracranial aneurysms is still not well defined. We aimed to compare rates of aneurysm occlusion and complications in patients covered with single versus multiple PEDs. Methods For this systematic review, we searched PubMed and SpringerLink databases, and citations for studies on September 2022. All peer-reviewed studies of adult patients diagnosed with intracranial aneurysm covered with single and multiple PEDs were assessed, and the rates of aneurysm occlusion and complications were collected, and have been published between April 20, 2011, and September 30, 2022. The risk of bias assessment was scored using the Newcastle–Ottawa Quality Assessment Scale for cohort studies. Evidence from studies was synthesized as narrative synthesis. Results A total of 5 studies with 772 patients and 795 aneurysms were included. A total of 531 (68.8%) patients were covered with a single PED, while 241 (31.2%) with multiple PEDs. The aneurysms are mostly located in the anterior circulation, with 93.84% in the single PED versus 86.08% in the multiple PEDs group. A total of 525 (92.58%) saccular types of aneurysms were covered in a single PED versus 222 (86.98%) in the multiple PEDs group. The overall aneurysms occlusion rates in approximately midterm follow-up were 72.34% in the single PED versus 87.04% in the multiple PEDs group. The overall complication rates among studies were 6.54% in a single PED versus 8.24% in the multiple PEDs group. Conclusions There is no significant difference in overall intracranial aneurysm occlusion rates when comparing single versus multiple PEDs coverage for treatment of aneurysms, primarily with longer follow-up times, with low and no significantly different complication rates between groups.
Bahar et al. (Tue,) studied this question.