title: Treatment of intra-cranial aneurysms with the SILK flow diverter: 2 years' experience with 28 patients at a single center.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Israel. maimonsm@zahav.net.il
authors.forename: Shimon
authors.initials: S
authors.lastname: Maimon
authors.forename: Lior
authors.initials: L
authors.lastname: Gonen
authors.forename: Erez
authors.initials: E
authors.lastname: Nossek
authors.forename: Ido
authors.initials: I
authors.lastname: Strauss
authors.forename: Ronen
authors.initials: R
authors.lastname: Levite
authors.forename: Zvi
authors.initials: Z
authors.lastname: Ram
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001807:Blood Vessel Prosthesis / Q000639:trends*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods; D057510:Endovascular Procedures / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome