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Treatment of Intracranial Aneurysms With the SILK Embolization Device in a Multicenter Study. A Retrospective Data Analysis

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...

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Autores principales: Pumar, José Manuel, Banguero, Alexandra, Cuellar, Hugo, Guimaraens, Leopoldo, Masso, Javier, Miralbes, Salvador, Blanco-Ulla, Miguel, Vazquez-Herrero, Fernando, Souto, Miguel, Gelabert-Gonzalez, Miguel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5808672/
https://www.ncbi.nlm.nih.gov/pubmed/28327963
http://dx.doi.org/10.1093/neuros/nyw123
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author Pumar, José Manuel
Banguero, Alexandra
Cuellar, Hugo
Guimaraens, Leopoldo
Masso, Javier
Miralbes, Salvador
Blanco-Ulla, Miguel
Vazquez-Herrero, Fernando
Souto, Miguel
Gelabert-Gonzalez, Miguel
author_facet Pumar, José Manuel
Banguero, Alexandra
Cuellar, Hugo
Guimaraens, Leopoldo
Masso, Javier
Miralbes, Salvador
Blanco-Ulla, Miguel
Vazquez-Herrero, Fernando
Souto, Miguel
Gelabert-Gonzalez, Miguel
author_sort Pumar, José Manuel
collection PubMed
description 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. Data regarding patient demographics, aneurysm characteristics, and technical procedure were analyzed. Angiographic and clinical findings were recorded during the procedure and at 12 months postoperatively. RESULTS: A total of 175 SFD devices were implanted in 157 patients (women/men: 119/38; mean, median, and range of age: 56.2, 56.7, and 19-80 years, respectively), who were treated in a delayed manner (3-6 months from the event) for 180 aneurysms (165 unruptured and 15 ruptured). Adverse events (acute and delayed) were observed in 28.7% of cases (45/157), and most were resolved (19.1%; 30/157). Six months after the procedure, total morbidity and mortality were 9.6% (15/157) and 3.2% (5/157), respectively. Long-term imaging follow-up showed complete occlusion, neck remnants, and residual aneurysm in 78.1% (100/128), 14.0% (18/128), and 7.8% (10/128) of cases, respectively. CONCLUSIONS: The SFD device is an effective tool for the treatment of challenging aneurysms, and allows complete occlusion within a year of the procedure in most patients, with morbidity and mortality comparable to those previously reported for similar devices.
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spelling pubmed-58086722018-02-14 Treatment of Intracranial Aneurysms With the SILK Embolization Device in a Multicenter Study. A Retrospective Data Analysis Pumar, José Manuel Banguero, Alexandra Cuellar, Hugo Guimaraens, Leopoldo Masso, Javier Miralbes, Salvador Blanco-Ulla, Miguel Vazquez-Herrero, Fernando Souto, Miguel Gelabert-Gonzalez, Miguel Neurosurgery Research—Human—Clinical Studies 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. Data regarding patient demographics, aneurysm characteristics, and technical procedure were analyzed. Angiographic and clinical findings were recorded during the procedure and at 12 months postoperatively. RESULTS: A total of 175 SFD devices were implanted in 157 patients (women/men: 119/38; mean, median, and range of age: 56.2, 56.7, and 19-80 years, respectively), who were treated in a delayed manner (3-6 months from the event) for 180 aneurysms (165 unruptured and 15 ruptured). Adverse events (acute and delayed) were observed in 28.7% of cases (45/157), and most were resolved (19.1%; 30/157). Six months after the procedure, total morbidity and mortality were 9.6% (15/157) and 3.2% (5/157), respectively. Long-term imaging follow-up showed complete occlusion, neck remnants, and residual aneurysm in 78.1% (100/128), 14.0% (18/128), and 7.8% (10/128) of cases, respectively. CONCLUSIONS: The SFD device is an effective tool for the treatment of challenging aneurysms, and allows complete occlusion within a year of the procedure in most patients, with morbidity and mortality comparable to those previously reported for similar devices. Oxford University Press 2017-10 2017-01-28 /pmc/articles/PMC5808672/ /pubmed/28327963 http://dx.doi.org/10.1093/neuros/nyw123 Text en © The Authors 2017. Published by Oxford University Press on behalf of Congress of Neurological Surgeons. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research—Human—Clinical Studies
Pumar, José Manuel
Banguero, Alexandra
Cuellar, Hugo
Guimaraens, Leopoldo
Masso, Javier
Miralbes, Salvador
Blanco-Ulla, Miguel
Vazquez-Herrero, Fernando
Souto, Miguel
Gelabert-Gonzalez, Miguel
Treatment of Intracranial Aneurysms With the SILK Embolization Device in a Multicenter Study. A Retrospective Data Analysis
title Treatment of Intracranial Aneurysms With the SILK Embolization Device in a Multicenter Study. A Retrospective Data Analysis
title_full Treatment of Intracranial Aneurysms With the SILK Embolization Device in a Multicenter Study. A Retrospective Data Analysis
title_fullStr Treatment of Intracranial Aneurysms With the SILK Embolization Device in a Multicenter Study. A Retrospective Data Analysis
title_full_unstemmed Treatment of Intracranial Aneurysms With the SILK Embolization Device in a Multicenter Study. A Retrospective Data Analysis
title_short Treatment of Intracranial Aneurysms With the SILK Embolization Device in a Multicenter Study. A Retrospective Data Analysis
title_sort treatment of intracranial aneurysms with the silk embolization device in a multicenter study. a retrospective data analysis
topic Research—Human—Clinical Studies
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5808672/
https://www.ncbi.nlm.nih.gov/pubmed/28327963
http://dx.doi.org/10.1093/neuros/nyw123
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