Treatment of Intracranial Aneurysms With the SILK Embolization Device in a Multicenter Study. A Retrospective Data Analysis.
BACKGROUND
Flow-diverter technology has become an important stent-based embolization tool in the treatment of complex cerebrovascular pathology. We report here the experience of 4 Spanish centers with using the SILK flow-diverter (SFD) device.


OBJECTIVE
To evaluate the safety and efficacy of using the SFD in the endovascular treatment of intracranial aneurysms with complex morphology.


METHODS
We retrospectively examined a prospectively maintained database of patients treated with SFD devices between July 2008 and December 2013 at 1 of 4 institutions in Spain. Data regarding patient demographics, aneurysm characteristics, and technical procedure were analyzed. Angiographic and clinical findings were recorded during the procedure and at 12 months postoperatively.


RESULTS
A total of 175 SFD devices were implanted in 157 patients (women/men: 119/38; mean, median, and range of age: 56.2, 56.7, and 19-80 years, respectively), who were treated in a delayed manner (3-6 months from the event) for 180 aneurysms (165 unruptured and 15 ruptured). Adverse events (acute and delayed) were observed in 28.7% of cases (45/157), and most were resolved (19.1%; 30/157). Six months after the procedure, total morbidity and mortality were 9.6% (15/157) and 3.2% (5/157), respectively. Long-term imaging follow-up showed complete occlusion, neck remnants, and residual aneurysm in 78.1% (100/128), 14.0% (18/128), and 7.8% (10/128) of cases, respectively.


CONCLUSIONS
The SFD device is an effective tool for the treatment of challenging aneurysms, and allows complete occlusion within a year of the procedure in most patients, with morbidity and mortality comparable to those previously reported for similar devices.
Department of Neuroradiology, Hospital Clinico Universitario, Universidad de Santiago de Compostela, Travesia de la Choupana s/n, Santiago de Compostela, Spain.
José Manuel
JM
Pumar
Department of Neuroradiology, Hospital Clinico Universitario, Universidad de Santiago de Compostela, Travesia de la Choupana s/n, Santiago de Compostela, Spain.
Alexandra
A
Banguero
Department of Neurosurgery and Radiology at LSU Health Sciences Center, Shreveport, Louisiana.
Hugo
H
Cuellar
Department of Interventional Neuroradiology, Hospital General de Cataluña, San Cugat, Barcelona, Spain.
Leopoldo
L
Guimaraens
Department of Neuroradiology, Hospital Universitario de Donostia, San Sebastian, Spain.
Javier
J
Masso
Department of Neuroradiology, Hospital Universitario Son Espases, Palma de Mallorca, Spain.
Salvador
S
Miralbes
Department of Neuroradiology, Hospital Clinico Universitario, Universidad de Santiago de Compostela, Travesia de la Choupana s/n, Santiago de Compostela, Spain.
Miguel
M
Blanco-Ulla
Department of Neuroradiology, Hospital Clinico Universitario, Universidad de Santiago de Compostela, Travesia de la Choupana s/n, Santiago de Compostela, Spain.
Fernando
F
Vazquez-Herrero
Department of Neuroradiology, Hospital Clinico Universitario, Universidad de Santiago de Compostela, Travesia de la Choupana s/n, Santiago de Compostela, Spain.
Miguel
M
Souto
Department of Neuroradiology, Hospital Clinico Universitario, Universidad de Santiago de Compostela, Travesia de la Choupana s/n, Santiago de Compostela, Spain.
Miguel
M
Gelabert-Gonzalez
D000328:Adult; D000368:Aged; D002533:Cerebral Angiography / Q000379:methods; D016208:Databases, Factual / Q000706:statistics & numerical data; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D013223:Statistics as Topic / Q000379:methods*; D016896:Treatment Outcome
Flow-diverter Embolization device; Intracranial aneurysm; SILK; Stent embolization