Silk flow-diverter stent for the treatment of complex intracranial aneurysms: A one-year follow-up multicenter study

Torres, G.; Roca, Federico; Noguera, Anna Fabra; Godes, Juan E; Petrocelli, Sergio H; Aznar, Iván L.; Ales, S; Muszynski, Patricio; Maehara, Reiko; Vicente, Moreira; Pumar, J.M.

doi:10.1177/1591019918771340

Cited by 19 publications

(8 citation statements)

References 32 publications

(88 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…1). 2,6,[14][15][16][17][18][19][20][21][22][23][24][25] All prospective and retrospective observational cohort studies were included.…”

Section: Search Resultsmentioning

confidence: 99%

“…After selection, 14 studies were chosen, 2,6,14-25 1 prospective observational cohort study and 13 retrospective observational cohort studies involving 1,021 patients treated for aneurysms. 2,6,[14][15][16][17][18][19][20][22][23][24][25] The mortality rate was 2.84% (95% confidence interval [CI] 0.00-2.75, P=0.83, I 2 =0%) (Table 1).…”

Section: Overview Of Included Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Silk® Flow Diverter Device for Intracranial Aneurysm Treatment: A Systematic Review and Meta-Analysis

Florez¹,

García-Ballestas²,

Quiñones-Ossa³

et al. 2021

Neurointervention

View full text Add to dashboard Cite

Flow diverters have become a critical instrument for complex aneurysms treatment. However, limited data are currently available regarding short and long-term outcomes for the Silk flow diverter. The objective of the study is to determine neurological prognosis and mortality rates for the Silk flow diversion device used in intracranial aneurysms. A systematic review with meta-analysis was performed using databases. The following descriptors were used for the search: “SILK”, “Flow Diverter”, “Mortality”, and “Prognosis”. The following data were extracted: mortality, good functional outcome, Glasgow outcome scale, complete or near-complete occlusion rates, rate of retreatment, and complications (thromboembolic and hemorrhagic complications). A total of 14 studies were selected. Among the 14 studies, 13 were retrospective observational cohort studies and 1 was a prospective observational cohort study. The mortality rate was 2.84%. The clinical good outcomes rate was 93.3%. The poor outcome rate was 6.6%. The overall thromboembolic complication rate was 6.06% (95% confidence interval [CI] 0.00–6.37, P=0.12, I2=3.13%). The total hemorrhagic complication rate was 1.62% (95% CI 0.00–5.34, P=0.28, I2=1.56%). The complete aneurysm occlusion rate was 80.4% (95% CI 8.65–9.38, P<0.0001, I2=9.09%). The Silk diverter device has a good safety and efficacy profile for treating intracranial aneurysms with high complete occlusion rates.

show abstract

“…1). 2,6,[14][15][16][17][18][19][20][21][22][23][24][25] All prospective and retrospective observational cohort studies were included.…”

Section: Search Resultsmentioning

confidence: 99%

Section: Overview Of Included Studiesmentioning

confidence: 99%

Silk® Flow Diverter Device for Intracranial Aneurysm Treatment: A Systematic Review and Meta-Analysis

Florez¹,

García-Ballestas²,

Quiñones-Ossa³

et al. 2021

Neurointervention

View full text Add to dashboard Cite

show abstract

“…The FD may change local hemodynamics rather than simply covering the ostium and may need some time for a complete thrombosis inside the aneurysm and intimal endothelialization of the FD after the flow has been modified. According to the literature, [27][28][29][30] the occlusion rate is variable. Our 6-month occlusion rate was slightly lower, but we found a similar rate at 12 months.…”

Section: Discussionmentioning

confidence: 99%

Large Neck and Strong Ostium Inflow as the Potential Causes for Delayed Occlusion of Unruptured Sidewall Intracranial Aneurysms Treated by Flow Diverter

Su¹,

Reymond²,

Brina³

et al. 2020

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

BACKGROUND AND PURPOSE: Flow diverter-induced hemodynamic change plays an important role in the mechanism of intracranial aneurysm occlusion. Our aim was to explore the relationship between aneurysm features and flow-diverter treatment of unruptured sidewall intracranial aneurysms. MATERIALS AND METHODS: MR imaging, 4D phase-contrast, was prospectively performed before flow diverter implantation in each patient with unruptured intracranial aneurysm. Two postprocedure follow-ups were scheduled at 6 and 12 months. Responses were grouped according to whether the aneurysms were occluded or remnant. Preprocedural aneurysm geometries and ostium hemodynamics in 38 patients were compared between the 2 groups at 6 and 12 months. Receiver operating characteristic curve analyses were performed for significant geometric and hemodynamic continuous parameters. RESULTS: After the 6-month assessment, 21 of 41 intracranial aneurysms were occluded, and 9 additional aneurysms were occluded at 12 months. Geometrically, the ostium maximum diameter was significantly larger in the remnant group at 6 and 12 months (both P , .001). Hemodynamically, the proximal inflow zone was more frequently observed in the remnant group at 6 months. Several preprocedural ostium hemodynamic parameters were significantly higher in the remnant group. As a prediction for occlusion, the areas under the curve of the ostium maximum diameter (for 6 and 12 months), systolic inflow rate ratio (for 6 months), and systolic inflow area (for 12 months) reached 0.843, 0.883, 0.855, and 0.860, respectively. CONCLUSIONS: Intracranial aneurysms with a large ostium and strong ostium inflow may need a longer time for occlusion. Preprocedural 4D flow MR imaging can well illustrate ostium hemodynamics and characterize aneurysm treatment responses.

show abstract

“…Silk device, achieving a complete occlusion rate of 93.9% with morbidity and mortality rates of 4.2% and 2.1%, respectively, at year follow-up. 41…”

Section: New Devices and Technologiesmentioning

confidence: 99%

Review of current intracranial aneurysm flow diversion technology and clinical use

Dandapat

Mendez‐Ruiz

Martínez‐Galdámez

et al. 2020

J NeuroIntervent Surg

104

View full text Add to dashboard Cite

Endovascular treatment of intracranial aneurysms (IAs) has evolved considerably over the past decades. The technological advances have been driven by the experience that coils fail to completely exclude all IAs from the blood circulation, the need to treat the diseased parent vessel segment leading to the aneurysm formation, and expansion of endovascular therapy to treat more complex IAs. Stents were initially developed to support the placement of coils inside wide neck aneurysms. However, early work on stent-like tubular braided structure led to a more sophisticated construct that then later was coined as a flow diverter (FD) and found its way into clinical application. Although FDs were initially used to treat wide-neck large and giant internal carotid artery aneurysms only amenable to surgical trap with or without a bypass or endovascular vessel sacrifice, its use in other types of IAs and cerebrovascular pathology promptly followed. Lately, we have witnessed an explosion in the application of FDs and subsequently their modifications leading to their ubiquitous use in endovascular therapy. In this review we aim to compile the available FD technology, evaluate the devices’ peculiarities from the authors’ perspective, and analyze the current literature to support initial and expanded indications, recognizing that this may be outdated soon.

show abstract

Silk flow-diverter stent for the treatment of complex intracranial aneurysms: A one-year follow-up multicenter study

Cited by 19 publications

References 32 publications

Silk® Flow Diverter Device for Intracranial Aneurysm Treatment: A Systematic Review and Meta-Analysis

Silk® Flow Diverter Device for Intracranial Aneurysm Treatment: A Systematic Review and Meta-Analysis

Large Neck and Strong Ostium Inflow as the Potential Causes for Delayed Occlusion of Unruptured Sidewall Intracranial Aneurysms Treated by Flow Diverter

Review of current intracranial aneurysm flow diversion technology and clinical use

Contact Info

Product

Resources

About