A pipeline stent is a treatment for a brain aneurysm. It’s a minimally invasive procedure that blocks blood flow through the affected part of the blood vessel.

A brain aneurysm is a weakened and bulging part of a blood vessel in your brain. A ruptured aneurysm can cause a stroke, which can lead to life-threatening complications. An estimated 6–16 people per 100,000 in the United States have a ruptured brain aneurysm each year.

Doctors treat brain aneurysms at risk of rupturing with surgery.

The first procedure doctors perform is often a flow diversion with a pipeline embolization device (PED). This surgery involves inserting a mesh stent into a blood vessel in your leg and guiding it through your bloodstream until it reaches your brain. The stent prevents blood from flowing into the aneurysm.

Research suggests that flow diversion devices have high success rates for treating brain aneurysms with low complication rates. Read on to learn more about the benefits of flow diversion with PEDs and what you can expect during the procedure.

The PED was the first flow diversion device used to treat unruptured brain aneurysms. Flow diversion devices fit inside an artery in your brain to reroute the flow of blood away from your aneurysm and reduce the chances that it will rupture.

The PED is produced by the company Medtronic. It’s been updated several times since its first approval in 2011, and the newest model is called the Pipeline Shield. This is a mesh cylinder made of a mixture of metals braided together, designed to reduce blood clotting compared to earlier models.

Flow diversion devices such as pipeline stents allow surgeons to avoid invasive brain surgery.

Surgeons can insert these stents into a blood vessel in your leg and guide them through your bloodstream with a long tube called a catheter until they reach your brain.

Before your procedure

You’ll likely need to undergo imaging tests such as magnetic resonance imaging (MRI) or angiography before your surgery so that your team can determine the exact location of your aneurysm.

You may receive blood tests to help determine your overall health.

Before your procedure, your doctor may give you medications to reduce your risk of blood clots. These medications are called anticoagulants.

You usually won’t be allowed to eat for at least 6 hours and drink 2 hours before your procedure.

During the procedure

On the day of your procedure, you’ll change into a hospital gown and be taken to the surgical room. Your team will consist of at least:

  • a neurosurgeon, an interventional radiologist, or a neurologist
  • an anesthesiologist
  • an imaging specialist
  • specially trained nurses

During your procedure:

  1. You’ll receive general anesthesia either through an injection into a vein or through a mask. General anesthesia puts you asleep.
  2. A small incision will be made in your femoral artery on your inner leg.
  3. Your neurosurgeon will thread a long and thin tube called a catheter through your bloodstream to the aneurysm. The catheter is narrower at the end to allow it to reach smaller blood vessels. One of several types of imaging will be used to make sure the stent is in the right place.
  4. When the catheter reaches your aneurysm, the stent will be fed through the catheter. When the stent is in place, it will expand to fill your blood vessel and block blood flow.

The procedure usually takes at least 90 minutes.

After your procedure, you’ll be taken to a recovery room where you’ll be monitored for side effects. If you don’t have any side effects, you may be able to go home within a couple of days. It’s not unusual to have tenderness in your groin.

Most people can return to normal activities like school or work within a week.

Receiving a pipeline stent is usually a safe procedure, but there’s a small risk of serious complications or a need for another surgery. Most studies report reoperation rates of around 3%.

Side effect rates are usually reported between 2.8% and 14.1%, and the risk of death ranges from 0% to 3.7%.

In a 2021 study, researchers found that 45% of side effects occurred within the first 3 days. Potential side effects include:

In 2021, Medtronic issued a recall of some of their devices after fractured pieces of their device lead to 10 serious injuries and 2 deaths. In the United States, the recall only applied to the Pipeline Flex Embolization Device.

Pipeline stents tend to have high success rates, with many studies reporting successful treatment in 75%–85.5% of people.

In a 2022 study, researchers examined the effectiveness of the newest type of pipeline device called the Pipeline Shield. In the study, 238 people were treated in 247 procedures.

Only 2 people needed retreatment at an 18-month follow-up. The blood vessel with the aneurysm was successfully blocked in 92.5% of cases. Three people in the study died in the follow-up period.

Researchers have begun to look at pipeline stents as a potential treatment option for aneurysms that have already ruptured. In a 2021 study, researchers found that 84.2% of a group of 38 people had favorable outcomes and 5 people died.

Pipeline stents are a minimally invasive option for treating unruptured brain aneurysms. The procedure involves inserting a mesh stent in a blood vessel in your leg and guiding it to your brain to block the flow of blood in an artery.

Pipeline stents have low rates of side effects and high success rates for treating unruptured aneurysms. However, there’s still a small risk of serious side effects, including death. Your doctor can give you the best idea of the potential risks.