title: SILK flow diverter for complex intracranial aneurysms: a Canadian registry.
abstract: BACKGROUND
  The SILK flow diverter (SFD) is used for the treatment of complex intracranial aneurysms. Small case series have been reported in the literature but few studies with a large number of patients have been published. We present our experience with the SFD for the treatment of intracranial aneurysms in Canada.
  
  
  METHODS
  Centers across Canada using SFDs were contacted to fill out a case report form for patients treated with an SFD in their center. Individual centers were responsible for approval from their ethics committee. Image analysis was performed by individual operators. The case report forms were collected and the final analysis was performed.
  
  
  RESULTS
  A total of 92 patients were treated with SFDs in eight centers in Canada between January 2009 and August 2013. The aneurysms were located in the posterior circulation in 16 patients and in the anterior circulation in 76 patients. Most aneurysms (75%) were saccular in shape; 22% were fusiform and 3% were blister aneurysms. The size of the aneurysms varied from 2 to 60 mm with the neck varying from 2 to 60 mm. Perioperative morbidity and mortality were 8.7% and 2.2%, respectively. At the last available follow-up, 83.1% of the aneurysms were either completely or near-completely occluded. The rate of complications was higher for fusiform aneurysms (p<0.001).
  
  
  CONCLUSIONS
  The SFD appears to be an important tool for the treatment of complex intracranial aneurysms. Treatment outcomes and complication rates remain a problem, but should be considered in the context of available alternative interventions. Ongoing analysis of flow-diverting stents for radiographic and clinical performance is required.
authors.affiliation: Division of Neuroradiology, Department of Diagnostic Imaging, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Jai Jai Shiva
authors.initials: JJ
authors.lastname: Shankar
authors.affiliation: Neurology and Neurosurgery, Montreal Neurological Hospital and Institute, Montreal, Quebec, Canada.
authors.forename: Donatella
authors.initials: D
authors.lastname: Tampieri
authors.affiliation: Division of Neuroradiology, Department of Diagnostic Imaging, The Ottawa Hospital, Ottawa, Ontario, Canada.
authors.forename: Daniela
authors.initials: D
authors.lastname: Iancu
authors.affiliation: Department of Radiology, Montreal Neurological Hospital and Institute, Montreal, Quebec, Canada.
authors.forename: Maria
authors.initials: M
authors.lastname: Cortes
authors.affiliation: Division of Neuroradiology, Department of Diagnostic Imaging, Toronto Western Hospital and University Health Network, Toronto, Ontario, Canada.
authors.forename: Ronit
authors.initials: R
authors.lastname: Agid
authors.affiliation: Department of Radiology, University of Toronto, Toronto Western Hospital and University Health Network, Toronto, Ontario, Canada.
authors.forename: Timo
authors.initials: T
authors.lastname: Krings
authors.affiliation: Department of Neurosurgery, University of Calgary, Calgary, Alberta, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Wong
authors.affiliation: Department of Neurosugery, Quebec City, Quebec, Canada.
authors.forename: Pascale
authors.initials: P
authors.lastname: Lavoie
authors.affiliation: Department of Radiology, CHUM, Hopital Notre-Dame, Montreal, Quebec, Canada.
authors.forename: Jimmy
authors.initials: J
authors.lastname: Ghostine
authors.affiliation: Division of Neuroradiology, Department of Diagnostic Imaging, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Basavraj
authors.initials: B
authors.lastname: Shettar
authors.affiliation: Interdisciplinary Research Team, IWK, Dalhousie Universtiy, Halifax, Nova Scotia, Canada.
authors.forename: Krsita
authors.initials: K
authors.lastname: Ritchie
authors.affiliation: Department of Radiology, CHUM, Hopital Notre-Dame, Montreal, Quebec, Canada.
authors.forename: Alain
authors.initials: A
authors.lastname: Weill
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada / Q000453:epidemiology; D002648:Child; D057510:Endovascular Procedures / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012042:Registries; D015607:Stents; D055815:Young Adult
keywords: Aneurysm; Device; Flow Diverter