Abstract
Background: Flow diverters are widely used as the first endovascular treatment option for complex brain aneurysms due to their high percentage of occlusion and low morbi-mortality. The Silk Vista device is a new generation of flow diverters designed to facilitate full visibility, improve apposition to the vessel wall, and enhance navigability. Indeed, its greatest advantage is that it enables the easier navigation of stents between 3.5 and 4.75 mm through a 0.021 microcatheter. The objective of this study was to evaluate the safety and effectiveness of Silk Vista systems for treating cerebral aneurysms.Methods: This prospective observational study included 25 consecutive patients with 27 wide-necked unruptured aneurysms treated with SILK Vista who were retrospectively analyzed for safety and efficacy.Results: Endovascular treatment was successfully performed in all patients. The final morbidity and mortality rates were both 0.0%. Short-term (3–5 months) angiographic follow-up revealed 21 complete occlusions and 6 near-complete occlusions. No significant parent artery stenosis was observed.Conclusions: This report demonstrates the efficacy of Silk Vista in treating brain aneurysms, although longer experiences should be carried out to confirm our results.
Highlights
IntroductionThe introduction of flow diverter stents represented a new treatment option for those cerebral brain aneurysms that could not be managed with the usual endovascular techniques [1,2,3].Since the Food and Drug Administration (FDA), in 2011, authorized the use of the first Flow diverter (Pipeline Embolization Device, Medtronic, Dublin, Ireland), flow diverters (FDs) began to be used representing an important option in the treatment of large and long brain aneurysms, obtaining satisfactory results both in the degree of occlusion and in the clinical efficacy [1,2,3,4,5,6,7,8]
The neurovascular community has been progressively increasing their use, developing a new-generation the flow diverters (FDs), with different structures, in order to produce better parent artery reconstruction and SILK Vista improve endothelial cells formation across the aneurysm neck (Silk flow diverter, Balt Extrusion, Montmorency, France; FRED, MicroVention, Tustin, CA; Derivo Embolization Device, Acandis GmbH, Germany; Surpass stent, Stryker Neurovascular, Kalamazoo, MI, USA; p64, Phenox GmbH, Bochum, Germany) [9,10,11,12,13,14]
Novel devices have been introduced several systems have been designed in order to reduce thromboembolic complications, facilitate navigability, improve radial force and radiopacity, including the development of FDs designed for the treatment of aneurysms beyond the Willis Circle (PED Shield, Medtronic, Dublin, Ireland; p48, Phenox GmbH, Bochum, Germany; Silk Vista Baby, Balt Extrusion, Montmorency, France; Fred Junior, MicroVention, Tustin, CA, USA) [15,16,17,18,19,20,21]
Summary
The introduction of flow diverter stents represented a new treatment option for those cerebral brain aneurysms that could not be managed with the usual endovascular techniques [1,2,3].Since the Food and Drug Administration (FDA), in 2011, authorized the use of the first Flow diverter (Pipeline Embolization Device, Medtronic, Dublin, Ireland), flow diverters (FDs) began to be used representing an important option in the treatment of large and long brain aneurysms, obtaining satisfactory results both in the degree of occlusion and in the clinical efficacy [1,2,3,4,5,6,7,8]. The neurovascular community has been progressively increasing their use, developing a new-generation the FDs, with different structures, in order to produce better parent artery reconstruction and SILK Vista improve endothelial cells formation across the aneurysm neck (Silk flow diverter, Balt Extrusion, Montmorency, France; FRED, MicroVention, Tustin, CA; Derivo Embolization Device, Acandis GmbH, Germany; Surpass stent, Stryker Neurovascular, Kalamazoo, MI, USA; p64, Phenox GmbH, Bochum, Germany) [9,10,11,12,13,14]. Novel devices have been introduced several systems have been designed in order to reduce thromboembolic complications, facilitate navigability, improve radial force and radiopacity, including the development of FDs designed for the treatment of aneurysms beyond the Willis Circle (PED Shield, Medtronic, Dublin, Ireland; p48, Phenox GmbH, Bochum, Germany; Silk Vista Baby, Balt Extrusion, Montmorency, France; Fred Junior, MicroVention, Tustin, CA, USA) [15,16,17,18,19,20,21]. The objective of this study was to evaluate the safety and effectiveness of Silk Vista systems for treating cerebral aneurysms
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