Device for treating patients with complex brain aneurysms

NICE, the healthcare guidance body, today (30 May) issued guidance on an innovative medical technology device which can benefit patients with complex brain aneurysms - a bulging blood vessel in the brain.

The NICE medical technology guidance supports the use of the Pipeline embolisation device in the NHS when it is used in patients with giant or complex intracranial aneurysms who would need large numbers of coils during stent-assisted coiling and who are unsuitable for neurosurgical treatment.

An aneurysm is a bulge in a blood vessel that'scaused by a weakness in the blood vessel wall. If an aneurysm in the brain ruptures, the resulting haemorrhage can cause death or serious brain damage and symptoms including sudden severe headache, stiff neck and nausea. 1 in 12,500 people will have a ruptured intracranial aneurysm in any given year in England.

The Pipeline embolisation device is a self-expanding blood flow diverter, loaded into and delivered via a microcatheter and placed across the neck of an intracranial aneurysm. Once in place, the blood flow through the parent vessel continues through the device, but the blood flow within the aneurysm sac is disrupted, leading to stagnation until it eventually forms a clot and is excluded from the circulation.

Professor Carole Longson, Health Technology Evaluation Centre Director at NICE, said, "We're pleased to publish this guidance supporting the Pipeline embolisation device for specific patients with giant or complex intracranial aneurysms. The independent NICE Medical Technologies Advisory Committee reviewed the evidence for adopting the Pipeline embolisation device in the NHS, and concluded that it has benefits for patients including a reduction in the symptoms caused by pressure of the bulging blood vessel on the brain, reduced rates of retreatment and a decreased rate of brain haemorrhage. In some clinical scenarios, using Pipeline is expected to save the NHS around £492 per procedure compared with standard treatment.

"We are also very keen for clinicians to submit details of all patients being treated with the Pipeline embolisation device to the UK Neurointerventional Radiology Group audit database, as the guidance recommends. This will increase the evidence base and help guide the future use of this technology."