Journal article
SILK Flow-Diverting Device for Intracranial Aneurysms
World neurosurgery, v 76(5), pp 477.e1-477.e6
01 Nov 2011
PMID: 22152578
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The SILK intracranial stent is a Conformité Européenne mark-approved endovascular device. This flow-diversion device is being used in Europe for intracranial aneurysm treatment by aneurysm occlusion. The device construct creates an intracranial bypass conduit that reconstructs the parent vessel while maintaining patency of the perforating arteries and branch arteries. The investigators report the first two patients in which the SILK stent was used for intracranial aneurysms in the United States.
Two patients, one with a symptomatic giant posterior communicating artery aneurysm and one with a symptomatic fusiform vertebrobasilar junction and basilar artery aneurysm, were treated at two separate institutions with the device. A total of three SILK stents were placed in these patients. In the first patient, a single device was sufficient to cause immediate angiographic stasis within the posterior communicating artery aneurysm. However, reversal of anticoagulation and antiplatelet therapy was required due to a spontaneous bleed from an intercostal artery, and this led to in-stent thrombosis and major stroke. In the second patient, the placement of two devices resulted in immediate stasis of the basilar artery aneurysm. The patient remained on antiplatelet therapy and was discharged without complication. His follow-up angiogram at approximately 2 months showed complete occlusion of the aneurysm with parent vessel reconstruction. In both patients, immediate stasis was identified, and no immediate neurological complications occurred. However, in one patient, a complication occurred that was related to reversal of/cessation of antiplatelet therapy.
In this initial U.S. experience with SILK flow-diversion devices, these devices were deployed easily and immediate flow stasis in the aneurysm was achieved. Further evaluation of this device is needed at multiple centers with adequately trained and experienced operators.
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Details
- Title
- SILK Flow-Diverting Device for Intracranial Aneurysms
- Creators
- Mandy J. Binning - University at Buffalo, State University of New YorkSabareesh K. Natarajan - University at Buffalo, State University of New YorkKetan R. Bulsara - Yale UniversityAdnan H. Siddiqui - University at Buffalo, State University of New YorkL. Nelson Hopkins - Kaleida HealthElad I. Levy - University at Buffalo, State University of New York
- Publication Details
- World neurosurgery, v 76(5), pp 477.e1-477.e6
- Publisher
- Elsevier
- Grant note
- University at Buffalo Toshiba Boston Scientific 1R01NS064592-01A1 / National Institutes of Health
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Web of Science ID
- WOS:000298342300029
- Scopus ID
- 2-s2.0-82955242948
- Other Identifier
- 991021918002104721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Surgery