Jai Jai Shiva Shankar1, Donatella Tampieri2, Daniela Iancu3, Maria Cortes4, Ronit Agid5, Timo Krings6, John Wong7, Pascale Lavoie8, Jimmy Ghostine9, Basavraj Shettar1, Krsita Ritchie10, Alain Weill9. 1. Division of Neuroradiology, Department of Diagnostic Imaging, Dalhousie University, Halifax, Nova Scotia, Canada. 2. Neurology and Neurosurgery, Montreal Neurological Hospital and Institute, Montreal, Quebec, Canada. 3. Division of Neuroradiology, Department of Diagnostic Imaging, The Ottawa Hospital, Ottawa, Ontario, Canada. 4. Department of Radiology, Montreal Neurological Hospital and Institute, Montreal, Quebec, Canada. 5. Division of Neuroradiology, Department of Diagnostic Imaging, Toronto Western Hospital and University Health Network, Toronto, Ontario, Canada. 6. Department of Radiology, University of Toronto, Toronto Western Hospital and University Health Network, Toronto, Ontario, Canada. 7. Department of Neurosurgery, University of Calgary, Calgary, Alberta, Canada. 8. Department of Neurosugery, Quebec City, Quebec, Canada. 9. Department of Radiology, CHUM, Hopital Notre-Dame, Montreal, Quebec, Canada. 10. Interdisciplinary Research Team, IWK, Dalhousie Universtiy, Halifax, Nova Scotia, Canada.
Abstract
INTRODUCTION: The SILK flow diverter (SFD) is used for the treatment of complex intracranial aneurysms. Small case series have been reported in the literature but few studies with a large number of patients have been published. We present our experience with the SFD for the treatment of intracranial aneurysms in Canada. METHODS: Centers across Canada using SFDs were contacted to fill out a case report form for patients treated with an SFD in their center. Individual centers were responsible for approval from their ethics committee. Image analysis was performed by individual operators. The case report forms were collected and the final analysis was performed. RESULTS: A total of 92 patients were treated with SFDs in eight centers in Canada between January 2009 and August 2013. The aneurysms were located in the posterior circulation in 16 patients and in the anterior circulation in 76 patients. Most aneurysms (75%) were saccular in shape; 22% were fusiform and 3% were blister aneurysms. The size of the aneurysms varied from 2 to 60 mm with the neck varying from 2 to 60 mm. Perioperative morbidity and mortality were 8.7% and 2.2%, respectively. At the last available follow-up, 83.1% of the aneurysms were either completely or near-completely occluded. The rate of complications was higher for fusiform aneurysms (p<0.001). CONCLUSIONS: The SFD appears to be an important tool for the treatment of complex intracranial aneurysms. Treatment outcomes and complication rates remain a problem, but should be considered in the context of available alternative interventions. Ongoing analysis of flow-diverting stents for radiographic and clinical performance is required. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
INTRODUCTION: The SILK flow diverter (SFD) is used for the treatment of complex intracranial aneurysms. Small case series have been reported in the literature but few studies with a large number of patients have been published. We present our experience with the SFD for the treatment of intracranial aneurysms in Canada. METHODS: Centers across Canada using SFDs were contacted to fill out a case report form for patients treated with an SFD in their center. Individual centers were responsible for approval from their ethics committee. Image analysis was performed by individual operators. The case report forms were collected and the final analysis was performed. RESULTS: A total of 92 patients were treated with SFDs in eight centers in Canada between January 2009 and August 2013. The aneurysms were located in the posterior circulation in 16 patients and in the anterior circulation in 76 patients. Most aneurysms (75%) were saccular in shape; 22% were fusiform and 3% were blister aneurysms. The size of the aneurysms varied from 2 to 60 mm with the neck varying from 2 to 60 mm. Perioperative morbidity and mortality were 8.7% and 2.2%, respectively. At the last available follow-up, 83.1% of the aneurysms were either completely or near-completely occluded. The rate of complications was higher for fusiform aneurysms (p<0.001). CONCLUSIONS: The SFD appears to be an important tool for the treatment of complex intracranial aneurysms. Treatment outcomes and complication rates remain a problem, but should be considered in the context of available alternative interventions. Ongoing analysis of flow-diverting stents for radiographic and clinical performance is required. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Authors: Francesco Briganti; Giuseppe Leone; Lorenzo Ugga; Mariano Marseglia; Antonio Macera; Andrea Manto; Luigi Delehaye; Maurizio Resta; Mariachiara Resta; Nicola Burdi; Nunzio Paolo Nuzzi; Ignazio Divenuto; Ferdinando Caranci; Mario Muto; Domenico Solari; Paolo Cappabianca; Francesco Maiuri Journal: J Neurointerv Surg Date: 2016-07-20 Impact factor: 5.836
Authors: Pervinder Bhogal; Victoria Hellstern; Hansjörg Bäzner; Oliver Ganslandt; Hans Henkes; Marta Aguilar Pérez Journal: Front Neurol Date: 2017-08-07 Impact factor: 4.003
Authors: P Bhogal; R Martinez Moreno; O Ganslandt; H Bäzner; H Henkes; M Aguilar Perez Journal: J Neurointerv Surg Date: 2016-10-27 Impact factor: 5.836