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Original research
SILK flow diverter for complex intracranial aneurysms: a Canadian registry
  1. Jai Jai Shiva Shankar1,
  2. Donatella Tampieri2,
  3. Daniela Iancu3,
  4. Maria Cortes4,
  5. Ronit Agid5,
  6. Timo Krings6,
  7. John Wong7,
  8. Pascale Lavoie8,
  9. Jimmy Ghostine9,
  10. Basavraj Shettar1,
  11. Krsita Ritchie10,
  12. Alain Weill9
  1. 1Division of Neuroradiology, Department of Diagnostic Imaging, Dalhousie University, Halifax, Nova Scotia, Canada
  2. 2Neurology and Neurosurgery, Montreal Neurological Hospital and Institute, Montreal, Quebec, Canada
  3. 3Division of Neuroradiology, Department of Diagnostic Imaging, The Ottawa Hospital, Ottawa, Ontario, Canada
  4. 4Department of Radiology, Montreal Neurological Hospital and Institute, Montreal, Quebec, Canada
  5. 5Division of Neuroradiology, Department of Diagnostic Imaging, Toronto Western Hospital and University Health Network, Toronto, Ontario, Canada
  6. 6Department of Radiology, University of Toronto, Toronto Western Hospital and University Health Network, Toronto, Ontario, Canada
  7. 7Department of Neurosurgery, University of Calgary, Calgary, Alberta, Canada
  8. 8Department of Neurosugery, Quebec City, Quebec, Canada
  9. 9Department of Radiology, CHUM, Hopital Notre-Dame, Montreal, Quebec, Canada
  10. 10Interdisciplinary Research Team, IWK, Dalhousie Universtiy, Halifax, Nova Scotia, Canada
  1. Correspondence to Dr Jai Jai Shiva Shankar, Department of Diagnostic Imaging, Division of Neuroradiology, QE II Hospital, Halifax, 5743 Southwood Drive, Halifax, Nova Scotia, Canada B3H1E6; shivajai1{at}gmail.com, shivajai1{at}rediffmail.com

Abstract

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. Image analysis was performed by individual operators. The case report forms were collected and the final analysis was performed.

Results A total of 92 patients were treated with SFDs in eight centers in Canada between January 2009 and August 2013. The aneurysms were located in the posterior circulation in 16 patients and in the anterior circulation in 76 patients. Most aneurysms (75%) were saccular in shape; 22% were fusiform and 3% were blister aneurysms. The size of the aneurysms varied from 2 to 60 mm with the neck varying from 2 to 60 mm. Perioperative morbidity and mortality were 8.7% and 2.2%, respectively. At the last available follow-up, 83.1% of the aneurysms were either completely or near-completely occluded. The rate of complications was higher for fusiform aneurysms (p<0.001).

Conclusions The SFD appears to be an important tool for the treatment of complex intracranial aneurysms. Treatment outcomes and complication rates remain a problem, but should be considered in the context of available alternative interventions. Ongoing analysis of flow-diverting stents for radiographic and clinical performance is required.

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