Treatment of intra-cranial aneurysms with the SILK flow diverter: 2 years’ experience with 28 patients at a single center

Maimon, S.; Gonen, Lior; Nossek, Erez; Strauss, Ido; Levite, Ronen; Ram, Zvi

doi:10.1007/s00701-012-1316-2

Cited by 53 publications

(55 citation statements)

References 16 publications

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“…In the inner part of a curve, the mesh attenuation of the device is higher than that in the outer curve because of tighter packing of the FDS. 23,24 The free-cell space is consequently reduced across the origin of the ophthalmic artery, which leads to a rapid decrease of the inflow of the vessel. 23,24 The persistency of an aspirative effect may allow patency of the ophthalmic artery, but it induces a defect of perfusion.…”

Section: Discussionmentioning

confidence: 99%

Visual Outcomes with Flow-Diverter Stents Covering the Ophthalmic Artery for Treatment of Internal Carotid Artery Aneurysms

Rouchaud¹,

Leclerc

Benayoun

et al. 2014

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 99%

Visual Outcomes with Flow-Diverter Stents Covering the Ophthalmic Artery for Treatment of Internal Carotid Artery Aneurysms

Rouchaud¹,

Leclerc

Benayoun

et al. 2014

AJNR Am J Neuroradiol

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“…The FD has achieved promising clinical results in treating large or giant aneurysms. 8 Computational fluid dynamic (CFD) simulations have been used to predict the flow disruption effects induced by flow-diverting stents. Some techniques for simulation of stent deployment were used for CFD calculation.…”

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confidence: 99%

Hemodynamic Changes by Flow Diverters in Rabbit Aneurysm Models

Huang

Cheng

et al. 2013

Stroke

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Background and Purpose-The effect of flow diverter (FD) on hemodynamic changes observed in aneurysms is inevitably affected by the actual structural configuration of deployed FD. We studied the resultant hemodynamic changes after implantation of FDs using computational fluid dynamic simulations based on micro-computed tomography reconstructions in rabbit aneurysm model. Methods-The FDs by micro-computed tomography images and vascular model based on rabbit-specific angiograms in 14 rabbits were reconstructed for computational fluid dynamic studies, and rabbit-specific inlet flow waveforms were used as boundary conditions. The occluded group (n=10) and unoccluded group (n=4) were divided according to the follow-up angiography. Hemodynamic parameters were separately evaluated for significance with respect to FD implantation and healing. Results-The normalized mean wall shear stress of the aneurysm sac and inflow volume were significantly reduced after FD deployment, and the relative residence time was significantly increased after treatment, without significant differences in mean pressure of aneurysm sac. When compared with the unoccluded group, the average relative residence time increment and percentage of inflow volume reduction in occluded group were higher. Additionally, the inlet of stream after FD deployment in the occluded group was more prevalent near the central region of the neck, whereas in the unoccluded group, it was more likely to occur near the proximal part of the neck. Conclusions-This

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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.…”

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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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Treatment of intra-cranial aneurysms with the SILK flow diverter: 2 years’ experience with 28 patients at a single center

Cited by 53 publications

References 16 publications

Visual Outcomes with Flow-Diverter Stents Covering the Ophthalmic Artery for Treatment of Internal Carotid Artery Aneurysms

Visual Outcomes with Flow-Diverter Stents Covering the Ophthalmic Artery for Treatment of Internal Carotid Artery Aneurysms

Hemodynamic Changes by Flow Diverters in Rabbit Aneurysm Models

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

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