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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...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2017
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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. |
format | Online Article Text |
id | pubmed-5808672 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
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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