Treatment of Intracranial Aneurysms Using the New Silk Vista Flow Diverter: Safety Outcomes at Short-Term Follow-Up

Abstract

Background: Flow diverters are widely used as the first endovascular treatment option for complex brain aneurysms due to their high percentage of occlusion and low morbi-mortality. The Silk Vista device is a new generation of flow diverters designed to facilitate full visibility, improve apposition to the vessel wall, and enhance navigability. Indeed, its greatest advantage is that it enables the easier navigation of stents between 3.5 and 4.75 mm through a 0.021 microcatheter. The objective of this study was to evaluate the safety and effectiveness of Silk Vista systems for treating cerebral aneurysms.Methods: This prospective observational study included 25 consecutive patients with 27 wide-necked unruptured aneurysms treated with SILK Vista who were retrospectively analyzed for safety and efficacy.Results: Endovascular treatment was successfully performed in all patients. The final morbidity and mortality rates were both 0.0%. Short-term (3–5 months) angiographic follow-up revealed 21 complete occlusions and 6 near-complete occlusions. No significant parent artery stenosis was observed.Conclusions: This report demonstrates the efficacy of Silk Vista in treating brain aneurysms, although longer experiences should be carried out to confirm our results.

Midterm follow-up after embolization of intracranial aneurysms proximal to the circle of Willis with the Silk Vista flow diverter: the I-MAMA registry

“…Compared with the previous generation of Silk FDs, the SVM has also higher radial force [ 8 ], and we observed a complete wall apposition immediately after stent deployment in 46/48 procedures (96%). This result is in line and even slightly superior to previous early experiences with the new generation of Silk Vista reported by Martinez-Galdámez [ 8 ] and Pumar [ 9 ] (92%, respectively). Moreover, the visibility of SVM seems enhanced.…”

“…The latter ran asymptomatic and resolved without clinical consequences with prolonged DAPT for further 6 months. Despite no signs of neointimal hyperplasia were reported by Pumar [ 9 ] with the use of the new generation of the Silk Vista, Caroff et al [ 13 ] already described this phenomenon more frequently associated with the use of first-generation Silk stent rather than other FD at short-term follow-up. Due to the few numbers observed and, even more important, to the use of different DAPT protocols used in this multicentre experience, further studies are needed to better assess its prevalence in short- to long-term follow-up with the new generation of SVM.…”

“…Overall, in this registry, only one patient experienced asymptomatic cerebellar ischemic lesions during early MRI follow-up. Considering the 0.0% of thromboembolic events in the Silk Vista cohort described by Pumar et al [ 9 ], the use of low-profile FDs could still be one of the possible explications of this very low complication rates, but these results should be confirmed by larger series.…”

Innovations in intracranial aneurysm treatment: a pilot study on the Choydar flow diverter

“…However, one of the major impediments associated with the technology employed for the implantation of FD devices is that most systems need to be delivered with microcatheters featuring an internal diameter of 0.027 in or greater ( 16 ). This factor may potentially augment the intricacy of the surgical intervention.…”