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Observational Study
. 2022 Oct;64(10):2031-2037.
doi: 10.1007/s00234-022-03003-x. Epub 2022 Jun 30.

Silk Vista Baby flow diverter stent for ruptured intracranial aneurysms: a retrospective observational study

Riccardo Russo  1 , Andrea Boghi  2 , Andrea Giorgianni  3 , Guido Andrea Lazzarotti  4 , Alessio Bozzi  5 , Fabrizio Chegai  5 , Andrea Saletti  6 , Gabriele Gallizioli  7 , Vladimir Gavrilovic  8 , Caterina Michelozzi  9 , Benedetto Petralia  10 , Francesco Lorenzo Gatti  11 , Tommaso Gorgatti  10 , Ivan Gallesio  12 , Concetto Cristaudo  13 , Marco Angelo Politi  13 , Stefano Molinaro  3 , Mauro Bergui  14
Affiliations
Observational Study

Silk Vista Baby flow diverter stent for ruptured intracranial aneurysms: a retrospective observational study

Riccardo Russo et al. Neuroradiology. 2022 Oct.

Abstract

Purpose: Flow diversion changed the approach to complex intracranial aneurysms, leading to a widespread use and a rapid technological evolution. Indeed, indications continued to expand, including ruptured intracranial aneurysms in selected cases. Recently, new devices have been designed specifically to target smaller vessels. Therefore, we conducted a multicenter study to evaluate clinical outcome, complications, and occlusion rate of patients with ruptured aneurysms treated with new generation low profile Silk Vista Baby (SVB) flow diverter stent (FD).

Methods: We performed a retrospective observational study on consecutive patients who underwent treatment with SVB for ruptured aneurysms at 12 Italian centers. Primary end point was favorable clinical outcome rate, defined as modified ranking score (mRS) of 0-2 at the 3 months. Secondary outcomes were complication rate, aneurysm re-rupture, and complete aneurysm occlusion at last radiological follow-up.

Results: Twenty-five patients were included; at 3 months' follow-up, 19 patients (79.1%) had favorable clinical outcome (mRS 0-2). Three patients (12.5%) died during follow-up. In-stent thrombosis occurred in two cases (8.3%), managed with glycoprotein IIb/IIIA and intra-stent angioplasty, without clinical consequences. In 18 (85.7%) patients, complete occlusion at 3 months was demonstrated. No rebleeding occurred during follow-up. Presentation with unfavorable World Federation of Neurosurgical Societies grading system (WFNS) and posterior circulation location were both significantly correlated with unfavorable clinical outcome (p = 0.005 and p = 0.02).

Conclusions: Our data suggests that low profile FD treatment of ruptured intracranial aneurysms located distally of the circle of Willis is feasible. New generation low profile FD may represent an alternative option in carefully selected cases.

Keywords: Endovascular treatment; Flow diverter stent; Ruptured aneurysms.

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