SILK flow diverter for complex intracranial aneurysms: a Canadian registry

Shankar, Jai; Tampieri, Donatella; Iancu, Daniela; Cortes, Maria; Agid, Ronit; Krings, Timo; Wong, John H.; Lavoie, Pascale; Ghostine, Jimmy; Shettar, Basavraj; Ritchie, Krista; Weill, Alain

doi:10.1136/neurintsurg-2015-011708

Cited by 53 publications

(32 citation statements)

References 26 publications

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“…However, this reflects the real-world scenario, where operators report their own outcomes. Moreover, the Canadian interventional group has carried out several registries of honest self-reporting of outcomes 21 22. The retrospective nature of reporting adds another layer of bias.…”

Section: Discussionmentioning

confidence: 99%

Canadian Registry of LVIS Jr for Treatment of Intracranial Aneurysms (CaRLA)

Shankar

Quateen

Weill

et al. 2016

J NeuroIntervent Surg

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Section: Discussionmentioning

confidence: 99%

Canadian Registry of LVIS Jr for Treatment of Intracranial Aneurysms (CaRLA)

Shankar

Quateen

Weill

et al. 2016

J NeuroIntervent Surg

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“…Furthermore, morbidity and mortality rates are similar to those reported in other series in the literature. 5,17,18,23 Finally, it is worth noting that the retrospective study design, small number of included cases, and prevalence of aneurysms of the ICA siphon (83%) and small aneurysms (78%) could represent certain limitations.…”

mentioning

confidence: 99%

Postprocedural, midterm, and long-term results of cerebral aneurysms treated with flow-diverter devices: 7-year experience at a single center

Briganti¹,

Leone²,

Cirillo

et al. 2017

Neurosurgical Focus

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OBJECTIVEFlow diversion has emerged as a viable treatment option for selected intracranial aneurysms and recently has been gaining traction. The aim of this study was to evaluate the safety and effectiveness of flow-diverter devices (FDDs) over a long-term follow-up period.METHODSThe authors retrospectively reviewed all cerebral aneurysm cases that had been admitted to the Division of Neurosurgery of the Università degli Studi di Napoli between November 2008 and November 2015 and treated with an FDD. The records of 60 patients (48 females and 12 males) harboring 69 cerebral aneurysms were analyzed. The study end points were angiographic evidence of complete aneurysm occlusion, recanalization rate, occlusion of the parent artery, and clinical and radiological evidence of brain ischemia. The occlusion rate was evaluated according to the O’Kelly-Marotta (OKM) Scale for flow diversion, based on the degree of filling (A, total filling; B, subtotal filling; C, entry remnant; D, no filling). Postprocedural, midterm, and long-term results were strictly analyzed.RESULTSComplete occlusion (OKM D) was achieved in 63 (91%) of 69 aneurysms, partial occlusion (OKM C) in 4 (6%), occlusion of the parent artery in 2 (3%). Intraprocedural technical complications occurred in 3 patients (5%). Postprocedural complications occurred in 6 patients (10%), without neurological deficits. At the 12-month follow-up, 3 patients (5%) experienced asymptomatic cerebral infarction. No further complications were observed at later follow-up evaluations (> 24 months). There were no reports of any delayed aneurysm rupture, subarachnoid or intraparenchymal hemorrhage, ischemic complications, or procedure- or device-related deaths.CONCLUSIONSEndovascular treatment with an FDD is a safe treatment for unruptured cerebral aneurysms, resulting in a high rate of occlusion. In the present study, the authors observed effective and stable aneurysm occlusion, even at the long-term follow-up. Data in this study also suggest that ischemic complications can occur at a later stage, particularly at 12–18 months. On the other hand, no other ischemic or hemorrhagic complications occurred beyond 24 months.

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“…EVT of ruptured aneurysms by SFD has been reported [58,[62][63][64]. The main limitations of FD stents in case of ruptured IAs are the need of a dual antiplatelet therapy and the delay for aneurysm occlusion.…”

Section: Expert Commentarymentioning

confidence: 97%

“…Shankar et al [64] have published the Canadian experience with SFD. Ninety-two patients were treated with SFDs in eight Canadian centers.…”

Section: Clinical Profile and Completed Studiesmentioning

confidence: 99%

The Silk flow-diverter stent for endovascular treatment of intracranial aneurysms

Alghamdi¹,

Morais²,

Scillia³

et al. 2015

Expert Review of Medical Devices

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Flow diverter (FD) stents represent a new endovascular technique developed for the treatment of complex intracranial aneurysms (wide neck, fusiform, large, and giant aneurysms) that are challenging for classic endovascular techniques such as coiling, balloon-assisted coiling and stent-assisted coiling. Low porosity, high metal coverage, and high pore density are the main properties of FD stents. These properties induce hemodynamic changes redirecting the blood flow away from the aneurysm and into the parent artery leading to gradual thrombosis of the aneurysm. FD stents also provide scaffolding for subsequent neoendothelial proliferation, and vessel wall remodeling. This is considered as a paradigm shift compared to prior endovascular methods, which predominantly aimed at providing treatment inside the aneurysmal sac. This paper describes in detail the first released FD stent, the Silk flow-diverter stent (Balt Extrusion, Montmorency, France), its mechanism of action and deployment technique. It reviews the pertinent literature regarding safety, efficacy and potential risks and complications associated with the use of this stent.

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SILK flow diverter for complex intracranial aneurysms: a Canadian registry

Cited by 53 publications

References 26 publications

Canadian Registry of LVIS Jr for Treatment of Intracranial Aneurysms (CaRLA)

Canadian Registry of LVIS Jr for Treatment of Intracranial Aneurysms (CaRLA)

Postprocedural, midterm, and long-term results of cerebral aneurysms treated with flow-diverter devices: 7-year experience at a single center

The Silk flow-diverter stent for endovascular treatment of intracranial aneurysms

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