Treatment of intra-cranial aneurysms with the SILK flow diverter: 2 years’ experience with 28 patients at a single center
- 9 March 2012
- journal article
- case report
- Published by Springer Science and Business Media LLC in Acta Neurochirurgica
- Vol. 154 (6), 979-987
- https://doi.org/10.1007/s00701-012-1316-2
Abstract
Flow diverters are recently developed stent-like endovascular devices developed to treat complex and non-coilable aneurysms. SILK is a type of flow diverter that has been used for nearly 3 years. Only sparse data about it are available. We would like to share our experience with this device. Twenty-eight patients were treated with SILK from October 2008 to October 2010. Thirty-one treatment sessions were performed for 32 aneurysms using 31 SILKs. Twenty have been treated with SILK only and eight with SILK and adjuvant stents. Twenty-six (86%) patients performed cross-sectional imaging (MRA/CTA) for follow-up. Eighteen (64%) patients had follow-up brain angiography. In all patients the SILK could be deployed. No case of early or late aneurysmal rupture was noted. Five patients (17.8%) developed immediate clinical complications, which were permanent in three (10.7%). All the complications occurred in patients harboring aneurysms larger than 15 mm. In two other patients, occlusion of the SILK was noted with no clinical deficit. A complete or near-complete aneurysmal occlusion was found in brain angiography or cross-sectional imaging follow-up in 83.3% of the patients. SILK is a relatively simple device to use, with a low rate of technical and clinical complications and a high short-term aneurysmal occlusion rate. In aneurysms smaller than 15 mm, the results are excellent. Results are also encouraging in the larger aneurysms, taking into consideration their complexity. The device characteristics and mainly its drawbacks must be well known by the users.Keywords
This publication has 16 references indexed in Scilit:
- Flow-Diverter Stent for the Endovascular Treatment of Intracranial AneurysmsStroke, 2010
- Long-term follow-up of endovascular coil embolization for cerebral aneurysms using three-dimensional time-of-flight magnetic resonance angiographyNeurological Research, 2009
- CURATIVE ENDOVASCULAR RECONSTRUCTION OF CEREBRAL ANEURYSMS WITH THE PIPELINE EMBOLIZATION DEVICENeurosurgery, 2009
- The Asymmetric Vascular StentStroke, 2009
- DEFINITIVE RECONSTRUCTION OF CIRCUMFERENTIAL, FUSIFORM INTRACRANIAL ANEURYSMS WITH THE PIPELINE EMBOLIZATION DEVICENeurosurgery, 2008
- Retreatment of Ruptured Cerebral Aneurysms in Patients Randomized by Coiling or Clipping in the International Subarachnoid Aneurysm Trial (ISAT)Stroke, 2007
- Progressive perianeurysmal edema induced after endovascular coil embolizationJournal of Neurosurgery, 2007
- Guglielmi Detachable Coil embolization of cerebral aneurysms: 11 years' experienceJournal of Neurosurgery, 2003
- International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: A randomized trialJournal Of Stroke & Cerebrovascular Diseases, 2002
- Intravascular stent and endovascular coil placement for a ruptured fusiform aneurysm of the basilar arteryJournal of Neurosurgery, 1997