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

• Published in: Neurointervention Vol. 16; no. 3; pp. 222 - 231
• Main Authors: Florez, William A, Garcia-Ballestas, Ezequiel, Quiñones-Ossa, Gabriel Alexander, Janjua, Tariq, Konar, Subhas, Agrawal, Amit, Moscote-Salazar, Luis Rafael
• Format: Journal Article
• Language: English
• Published: Korean Society of Interventional Neuroradiology 01.11.2021; 대한신경중재치료의학회
• Subjects: aneurysm; cerebrovascular circulation; intracranial aneurysm; neurosurgery; neurosurgical procedures; Review; 방사선과학
• ISSN: 2093-9043; 2233-6273
• DOI: 10.5469/neuroint.2021.00234

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.