Efficacy and safety of use of flow diverting silk stent in endovascular treatment of intracranial aneurysms

Abstract Efficacy and Safety of Use of Flow Diverting Silk Stent in Endovascular Treatment of Intracranial Aneurysms Objective: It was aimed to determine the feasibility, efficacy and safety of the treatment technique in patients with intracranial aneurysm treated with the flow converting Silk stent, between November 2011 and June 2019, in the Interventional Radiology unit of Istanbul University, Istanbul Medical Faculty, Department of Radiology. Methods: The study included 75 patients , with at least six months of angiographic follow-up and long-term follow-up imaging, with 95 aneurysms treated in 78 different procedures. The patients' pre-treatment, post-treatment and follow-up clinical data, technical procedure results, demographic characteristics, aneurysm characteristics and localizations, occlusion rates, early and late mortality rates, and permanent morbidity rates were analyzed retrospectively from the image archive system and their files. Results: According to the morphology of the aneurysms included in the study, 89 (93.7%) were saccular, 2 were fusiform (2.1%), 2 (2.1%) were blister, 2 (2.1%) were dissected; according to their size, 31 (32.63%) small, 40 (42.11%) medium, 11 (11.58%) large, 13 (13.58%) giant; according to their localization 87 (91.58%) anterior circulation, 8 (8.42%) posterior circulation ; according to wall placement 91 (95.79%) lateral, 4 (4.21%) bifurcation; according to aspect ratio, 40 (42.11%) had a narrow neck and 52 (54.73%) had a wide neck. Two of the patients were treated for ruptured blister aneurysm. Aneurysm occlusion rates were found to be 87.2% at 12th months, and 93.68% at long-term follow-up. A total of 9 patients (11.53%) developed procedural complications. In angiographic long-term follow-ups, it was found that postprocedural late complications developed in 7 patients (8.9%). The overall mortality rate was 5.33%, with postprocedural early 2.66% and late 2.66%. The permanent morbidity rate was found to be 1.33%. The mean follow-up period of the aneurysms was 42.68 (±26.5) months, and the mean occlusion time was 8.76 (± 8.3) months. Conclusion: When the high occlusion rate and low complication levels obtained in the study were evaluated, it was concluded that the use of flow-diverting Silk stent was effective and safe in the endovascular treatment of intracranial aneurysms. It has been determined that technical success is worse in posterior circulation aneurysms compared to anterior, and mortality and morbidity rates are lower in anterior circulation. Keywords: Intracranial Aneurysm, Endovascular Treatment, Flow Conversion Silk Stent