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Silk flow diverter

José Manuel Pumar, Alexandra Banguero, Hugo Cuellar, Leopoldo Guimaraens, Javier Masso, Salvador Miralbes, Miguel Blanco-Ulla, Fernando Vazquez-Herrero, Miguel Souto, Miguel Gelabert-Gonzalez
BACKGROUND: Flow-diverter technology has become an important stent-based embolization tool in the treatment of complex cerebrovascular pathology. We report here the experience of 4 Spanish centers with using the SILK flow-diverter (SFD) device. OBJECTIVE: To evaluate the safety and efficacy of using the SFD in the endovascular treatment of intracranial aneurysms with complex morphology. METHODS: We retrospectively examined a prospectively maintained database of patients treated with SFD devices between July 2008 and December 2013 at 1 of 4 institutions in Spain...
January 28, 2017: Neurosurgery
Ahmet Peker, Erol Akgul, Ergun Daglioglu, Ilkay Akmangit, Tunca Kaya, Deniz Belen, Anil Arat
AIM: To report the initial experience of cerebral aneurysm treatment with Tapered flow diverters (TFDs). MATERIAL AND METHODS: Thirty patients with 34 aneurysms underwent cerebral aneurysm treatment with TFD (Silk, Balt, Montmorency, France) between March 2011 and March 2016. Procedural findings, complications, clinical and imaging follow-up were assessed retrospectively. RESULTS: The patients' mean age was 48±14.5 years (range, 16-74; 25 females)...
May 25, 2016: Turkish Neurosurgery
Enes Duman, İlker Çöven, Erkan Yildirim, Cem Yilmaz, Ulaş Pinar
AIM: Flow diverter (FD) stents have been used in the treatment of unruptured intracranial aneurysms. There are a few studies that report the use of these devices in ruptured blister-like aneurysms. We present 5 consecutive patients, who have ruptured intracranial wide necked or side branch close to the neck of saccular aneurysms, have no other treatment options, treated with FD stents and coil embolization. MATERIAL AND METHODS: Between September 2012 and April 2015, 139 ruptured aneurysms of 133 consequent patients were treated...
December 28, 2015: Turkish Neurosurgery
Guilherme Cabral de Andrade, Helvercio P Alves, Valter Clímaco, Eduardo Pereira, Alexandre Lesczynsky, Michel E Frudit
Intracranial circumferential fusiform aneurysms of the posterior circulation involving arterial branches or perforating vessels are difficult to treat. This article shows an endovascular reconstruction technique not yet described, using a telescoping self-expandable stent (LEO+) and flow-diverter device (SILK) at different surgical times. Two patients with circumferential fusiform aneurysm, one being an aneurysm of the segments P2 and P3 of the posterior cerebral artery, diagnosed after a headache, and the other a partially thrombosed aneurysm of the lower basilar artery, diagnosed following ischemia of the brain stem...
October 2016: Interventional Neuroradiology
Tunca Kaya, Ergun Daglioglu, Erdem Gurkas, Ilkay Akmangit, Ahmet Peker, Deniz Belen, Dogan Dede, Atilla Halil Elhan, Anil Arat
AIM: To report patient and procedure-related factors affecting the angiographic and clinical outcome in patients treated with the Silk device. MATERIAL AND METHODS: All patients with intracranial aneurysms in whom treatment was attempted with the Silk flow diverter by our neurovascular team between October 2010 and November 2013 were included consecutively. The data was analyzed by an independent stroke neurologist not involved in the treatment of the patients. RESULTS: A total of 96 patients (64 female) with ages range from 3 to 78 were included in this study...
2016: Turkish Neurosurgery
Erdem Gurkas, Tunca Kaya, Ergun Daglioglu, Ilkay Akmangit, Deniz Belen, Ahmet Peker, Dogan Dede, Anil Arat
AIM: We evaluated the procedural outcomes of intracranial aneurysm treatment with the Silk device and its relation with operator experience. We also detailed some technical points we learned throughout our experience. MATERIAL AND METHODS: One hundred and six consecutive patients with intracranial aneurysms treated using Silk (BaltExtrusion, Montmorency, France) stent between October 2010 and November 2013 were included. Patients were evaluated in terms of age, sex, aneurysm size, location, technical success, and adverse events...
2016: Turkish Neurosurgery
Brian P Walcott, Christopher J Stapleton, Omar Choudhri, Aman B Patel
IMPORTANCE: Brain aneurysms have traditionally been treated with surgical clipping or endovascular coiling techniques. With these modalities, many large or complex aneurysms remain difficult to treat. A new option, flow diversion, is now available to treat aneurysms. OBJECTIVE: To summarize the clinical progression of flow diversion technology, from an experimental treatment to a commonly used method to treat large or complex aneurysms. EVIDENCE REVIEW: References for this topical review were identified by searches of PubMed and GoogleScholar between January 2000 and January 2016...
August 1, 2016: JAMA Neurology
Wesley S Moore, Brian G DeRubertis
BACKGROUND: Carotid stent and/or angioplasty (CAS) via the transfemoral route with distal protection carries twice the risk of stroke and/or death when compared with carotid endarterectomy (CEA) in multiple randomized trials. Potential causes for this include disadvantaged aortic arch anatomy and the need to traverse the lesion to place a distal protection device. This report describes the technique and our experience with direct CAS using flow reversal for embolic protection. METHODS: University of California at Los Angeles (UCLA) division of Vascular and Endovascular surgery was a participant in the multi-institutional Roadster Trial of high-risk patients...
May 2016: Annals of Vascular Surgery
C Karmonik, J R Anderson, J Beilner, J J Ge, S Partovi, R P Klucznik, O Diaz, Y J Zhang, G W Britz, R G Grossman, N Lv, Q Huang
BACKGROUND AND PURPOSE: To quantify the relationship and to demonstrate redundancies between hemodynamic and structural parameters before and after virtual treatment with a flow diverter device (FDD) in cerebral aneurysms. METHODS: Steady computational fluid dynamics (CFD) simulations were performed for 10 cerebral aneurysms where FDD treatment with the SILK device was simulated by virtually reducing the porosity at the aneurysm ostium. Velocity and pressure values proximal and distal to and at the aneurysm ostium as well as inside the aneurysm were quantified...
July 26, 2016: Journal of Biomechanics
Ido Strauss, Shimon Maimon
BACKGROUND: Flow diverters are used to treat complex aneurysms that are not amenable to coiling. The aim of the present work was to retrospectively evaluate our experience with the Silk flow diverter. Technical nuances and complications are specifically discussed. METHODS: Retrospectively data was collected on patients treated with Silk between October 2008 and October 2013. RESULTS: Sixty patients harboring 67 aneurysms were treated using the Silk...
February 2016: Acta Neurochirurgica
Faisal Alghamdi, Ricardo Morais, Pietro Scillia, Boris Lubicz
Flow diverter (FD) stents represent a new endovascular technique developed for the treatment of complex intracranial aneurysms (wide neck, fusiform, large, and giant aneurysms) that are challenging for classic endovascular techniques such as coiling, balloon-assisted coiling and stent-assisted coiling. Low porosity, high metal coverage, and high pore density are the main properties of FD stents. These properties induce hemodynamic changes redirecting the blood flow away from the aneurysm and into the parent artery leading to gradual thrombosis of the aneurysm...
2015: Expert Review of Medical Devices
Francesco Briganti, Giuseppe Leone, Mariano Marseglia, Giuseppe Mariniello, Ferdinando Caranci, Arturo Brunetti, Francesco Maiuri
BACKGROUND: Flow-diverter devices (FDDs) are new-generation stents placed in the parent artery at the level of the aneurysm neck to disrupt the intra-aneurysmal flow thus favoring intra-aneurysmal thrombosis. OBJECTIVE: The objective of this review article is to define the indication and results of the treatment of intracranial aneurysms by FDD, reviewing 18 studies of endovascular treatment by FDDs for a total of 1704 aneurysms in 1483 patients. METHODS: The medical literature on FDDs for intracranial aneurysms was reviewed from 2009 to December 2014...
August 2015: Neuroradiology Journal
F Clarençon, F Di Maria, J Gabrieli, E Shotar, C Zeghal, A Nouet, J Chiras, N-A Sourour
BACKGROUND AND PURPOSE: Flow diverter stents (FDSs) are increasingly used for the treatment of intracranial aneurysms. Initially developed for the management of giant and large aneurysms, their indications have progressively expanded. The purpose of our study was to evaluate the safety and effectiveness of FDSs for the treatment of anterior cerebral artery (ACA) aneurysms. MATERIALS AND METHODS: Among the 94 consecutive patients treated for 100 intracranial aneurysms by means of FDSs in our institution from October 2010 to January 2015, eight aneurysms (8 %) in seven patients were located on the ACA...
August 7, 2015: Clinical Neuroradiology
Daniel M Heiferman, Joshua T Billingsley, Manish K Kasliwal, Andrew K Johnson, Kiffon M Keigher, Michel E Frudit, Roham Moftakhar, Demetrius K Lopes
Flow-diverting stents, including the Pipeline embolization device (PED) and Silk, have been beneficial in the treatment of aneurysms previously unable to be approached via endovascular techniques. Recurrent aneurysms for which stent-assisted embolization has failed are a therapeutic challenge, given the existing intraluminal construct with continued blood flow into the aneurysm. We report our experience using flow-diverting stents in the repair of 25 aneurysms for which stent-assisted embolization had failed...
July 2016: Journal of Neurointerventional Surgery
(no author information available yet)
In issue 21.1 three of the DOIs were printed incorrectly, please see below for the correct information. Andrea Giorgianni, et al. Flow-diverter stenting of post-traumatic bilateral anterior cerebral artery pseudoaneurysm: A case report. Doi: 10.15274/INR-2014-10059 Correct: Doi: 10.1177/1591019915575441 Lee-Anne Slater, et al. Effect of flow diversion with silk on aneurysm size: A single center experience. Doi: 10.15274/INR-2014-10062 Correct DOI: 10.1177/1591019915576433 Robert J McDonald, et al. Periprocedural safety of Pipeline therapy for unruptured cerebral aneurysms: Analysis of 279 Patients in a multihospital database...
April 2015: Interventional Neuroradiology
Daniela Iancu, Cheemum Lum, Muhammad E Ahmed, Rafael Glikstein, Marlise P Dos Santos, Howard Lesiuk, Mohamed Labib, Amin B Kassam
We describe a case of iatrogenic carotid injury with secondary carotid-cavernous fistula (CCF) treated with a silk flow diverter stent placed within the injured internal carotid artery and coils placed within the cavernous sinus. Flow diverters may offer a simple and potentially safe vessel-sparing option in this rare complication of transsphenoidal surgery. The management options are discussed and the relevant literature is reviewed.
June 2015: Interventional Neuroradiology
Anastasios Mpotsaris, Martin Skalej, Oliver Beuing, Bernd Eckert, Daniel Behme, Werner Weber
BACKGROUND AND PURPOSE: The purpose of this article is to report on the long-term success rates of Silk flow-diverter (FD) treatment in a multicenter prospective study for the treatment of complex aneurysms. METHODS: Between May 2008 and January 2011, all consecutive patients featuring complex intracranial aneurysms eligible for FD treatment with the Silk in three neurovascular centers were included. Clinical and imaging data were assessed during hospitalization and follow-up...
June 2015: Interventional Neuroradiology
Jai Jai Shiva Shankar, Donatella Tampieri, Daniela Iancu, Maria Cortes, Ronit Agid, Timo Krings, John Wong, Pascale Lavoie, Jimmy Ghostine, Basavraj Shettar, Krsita Ritchie, Alain Weill
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...
March 2016: Journal of Neurointerventional Surgery
Miran Skrap, Benedetto Petralia, Giovanni Toniato
BACKGROUND: This case study reports on a combined therapy of stenting and surgery for a giant unruptured middle cerebral artery (MCA) aneurysm with the aim of preserving the patency of the vessel during surgery. CASE DESCRIPTION: A 51-year-old male presented with a sudden onset of moderate left hemiparesis and dysarthria. Neuro-radiological evaluations showed a giant right unruptured MCA aneurysm without subarachnoid hemorrhage (SAH). The cerebral angiography confirmed the presence of such an aneurysm producing compression of both M2 branches with consequent slowing of the blood flow...
2015: Surgical Neurology International
Leonardo Giacomini, Ronie L Piske, Carlos E Baccin, Marcelo Barroso, Andrei F Joaquim, Helder Tedeschi
BACKGROUND: Flow diverter stents represent a new endovascular tool to treat complex aneurysms, such as giant, large, wide-necked and fusiform. The highly dense mash of these stents reduces inflow and outflow inside the aneurysm, resulting in intra aneurysmal thrombosis and stent endothelialization. OBJECTIVES: To present the results of treatment of intracranial aneurysms with flow diverter stents in a single center. METHODS: Retrospective review of 77 patients with 87 aneurysms treated using two different types of flow diverter stent, the Pipeline Embolization Device and SILK stent, between October 2010 and September 2013 in an interventional neuroradiology center...
June 2015: Interventional Neuroradiology
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