Flow-Diverter Silk Stent for the Treatment of Intracranial Aneurysms: 1-year Follow-Up in a Multicenter Study

• Published in: American journal of neuroradiology : AJNR Vol. 33; no. 6; pp. 1150 - 1155
• Main Authors: Berge, J., Biondi, A., Machi, P., Brunel, H., Pierot, L., Gabrillargues, J., Kadziolka, K., Barreau, X., Dousset, V., Bonafé, A.
• Format: Journal Article
• Language: English
• Published: Oak Brook, IL American Society of Neuroradiology 01.06.2012
• Subjects: Adult; Aged; Biological and medical sciences; Blood Vessel Prosthesis; Cardiovascular system; Embolization, Therapeutic - instrumentation; Female; Follow-Up Studies; Humans; Interventional; Intracranial Aneurysm - diagnostic imaging; Intracranial Aneurysm - surgery; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Nervous system; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radiography; Silk; Stents; Treatment Outcome; Young Adult; Vascular disease; Intracranial; Nervous system diseases; Silk; Treatment; Radiodiagnosis; Follow up study; Aneurysm; Cardiovascular disease; Stent
• ISSN: 0195-6108; 1936-959X; 1936-959X
• DOI: 10.3174/ajnr.A2907

FD stent placement is a promising therapy for challenging intracranial aneurysms. Long-term evaluations about angiographic and morphologic results are still missing. This is the aim of this multicenter series. We report our experience and 1-year FU in a retrospective chart review of 65 consecutive subjects with 77 unruptured or recanalized aneurysms that were treated with Silk FD stents at 6 centers in France. Both angiographic and clinical results were recorded before treatment and at 6 and 12 months after treatment. At the 12-month FU, relationships between angiographic aneurysm occlusion and shrinkage of the thrombosed aneurysm sac were evaluated. Stent deployment was achieved in 64 cases (98.5%) and failed in 1 case (1.5%). Seven misdeployments of the Silk stent caused the occlusion of 6 parent arteries. Overall acute/subacute procedural morbidity was 7.7%, and mortality was zero. Delayed complications were observed in 10.9% of subjects. At the 6-month FU, permanent morbidity was 7.8% and mortality was 3%. Complete occlusion occurred within 6 months in 68% of aneurysms and within 12 months after treatment in 84.5% of aneurysms. At the 12-month FU, in angiographically complete occluded aneurysms, MR imaging/CT analysis showed the complete disappearance of the thrombosed aneurysm in 30% of cases and partial shrinkage in 52%; furthermore, thrombosed aneurysms were stable in 11% of cases and enlarged in 7%. The Silk stent is an effective tool for the treatment of challenging aneurysms because it allows complete occlusion in most cases 1 year after treatment. Permanent morbidity was 7.8%, and mortality was 3%.