title: Treatment of complex intracranial aneurysms using flow-diverting silk® stents. An analysis of 32 consecutive patients.
abstract: This study describes the peri-procedural and late complications and angiographic follow-up results of 32 patients with 34 complex aneurysms treated with flow diverter Silk stents in a single centre. In this retrospective study, 40 Silk stents (SS) were implanted in 34 complex intracranial aneurysms in 32 patients. In our series, 20 (58.8%) carotid-ophthalmic internal carotid artery (ICA), six (17.6%) cavernous ICA, two (5.9%) supraclinoid ICA, two (5.9%) petrosal ICA (the same patient- bilateral) and four (11.8%) posterior circulation aneurysms were treated. One of the posterior circulation lesions was a fenestrated-type aneurysm. Twenty wide-necked, saccular; eight neck remnant; four fusiform and two blister-like aneurysms were included in our series. SS were successfully implanted in all patients (100%). Misdeployment occurred in 17.6% of patients. In two of these patients adequate stent openness was achieved via Hyperglide balloon dilatation. Coil embolization in addition to SS placement was utilized in four aneurysms. One patient (3%) experienced transient morbidity due to a thromboembolic event and there was one mortality (3%) due to remote intraparenchymal haemorrhage. Complete occlusion of 27/33 (81.8 %) and 29/33 (87.9 %) aneurysms was achieved six and 12 months after the procedure, respectively. In-stent intimal hyperplasia was detected in 6.1 % patients. Flow-diverter Silk stent implantation is an effective method of treating complex aneurysms with acceptable mortality and morbidity rates. Complete occlusion is achieved in most of the complex aneurysms.
authors.affiliation: Department of Radiology, Düzce University Medical School; Düzce, Turkey - rbuyukkaya@gmail.com.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Buyukkaya
authors.affiliation: Department of Neurosurgery, Uludag University Medical School; Bursa, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Kocaeli
authors.affiliation: Department of Radiology, Uludag University Medical School; Bursa, Turkey.
authors.forename: Nalan
authors.initials: N
authors.lastname: Yildirim
authors.affiliation: Department of Radiology, Uludag University Medical School; Bursa, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Cebeci
authors.affiliation: Department of Radiology, Uludag University Medical School; Bursa, Turkey.
authors.forename: Cüneyt
authors.initials: C
authors.lastname: Erdogan
authors.affiliation: Department of Radiology, Uludag University Medical School; Bursa, Turkey.
authors.forename: Bahattin
authors.initials: B
authors.lastname: Hakyemez
mesh_terms: D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012189:Retrospective Studies; D047011:Silk; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D047011:Silk
keywords: Silk stent; cerebral aneurysms; endovascular treatment; flow diverter