Turkish Neurosurgery 2016 , Vol 26 , Num 4
Silk Device for the Treatment of Intracranial Aneurysms, Part 2: Factors Related to Clinical and Angiographic Outcome
Tunca KAYA1, Ergun DAGLIOGLU2, Erdem GURKAS3, Ilkay AKMANGIT1,4, Ahmet PEKER4, Deniz BELEN2, Dogan DEDE1, Atilla Halil ELHAN5, Anil ARAT1,4
1Ankara Numune Training and Research Hospital, Department of Radiology, Ankara, Turkey
2Ankara Numune Training and Research Hospital, Department of Neurosurgery, Ankara, Turkey
3Ankara Numune Training and Research Hospital, Department of Neurology, Ankara, Turkey
4Hacettepe University, School of Medicine, Department of Radiology, Ankara, Turkey
5Ankara University, School of Medicine, Department of Biostatistics, Ankara, Turkey
DOI : 10.5137/1019-5149.JTN.14760-15.0 AIM: To report patient and procedure-related factors affecting the angiographic and clinical outcome in patients treated with the Silk device.

MATERIAL and METHODS: All patients with intracranial aneurysms in whom treatment was attempted with the Silk flow diverter by our neurovascular team between October 2010 and November 2013 were included consecutively. The data was analyzed by an independent stroke neurologist not involved in the treatment of the patients.

RESULTS: A total of 96 patients (64 female) with ages range from 3 to 78 were included in this study. We found that 54 of the patients were asymptomatic and 42 of them symptomatic, while 21 had a prior history of subarachnoid hemorrhage (SAH). Mean aneurysm size was 10.2 mm (range 2 to 40 mm). 2 patients died due to consequences of SAH. 3 patients developed visual decline on the follow-up, 2 of these were procedure-related. Symptomatic thromboembolic events were noted in 7 cases. Patients with aneurysms smaller than 13 mm had significantly less complications and higher occlusion rates. The complication rate was significantly high in patients admitted with symptoms. Adjunctive coiling had no impact on outcome.

CONCLUSION: Safety and efficacy of flow diversion in this series was closely related to aneurysm size and presenting symptoms. A size cut-off for safety and efficacy has not been reported before and will be useful not only for future studies but also for patient counseling in daily practice. The futility of adjunctive coiling in this series calls for reappraisal of the current recommendations for this specific device. Keywords : Silk device, Intracranial aneurysms, Outcome

Corresponding author : Anl Arat, numuneanjio@gmail.com