AUTHOR=Schüngel Marie-Sophie , Quäschling Ulf , Weber Erik , Struck Manuel Florian , Maybaum Jens , Bailis Nikolaos , Arlt Felix , Richter Cindy , Hoffmann Karl-Titus , Scherlach Cordula , Schob Stefan 

TITLE=Endovascular Treatment of Intracranial Aneurysms in Small Peripheral Vessel Segments—Efficacy and Intermediate Follow-Up Results of Flow Diversion With the Silk Vista Baby Low-Profile Flow Diverter

JOURNAL=Frontiers in Neurology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.671915

DOI=10.3389/fneur.2021.671915

ISSN=1664-2295

ABSTRACT=Background and Purpose:
Low-profile flow diverter stents (FDS) quite recently amended peripheral segments as targets for hemodynamic aneurysm treatment, however, reports on outcomes, especially later than 3months, are scarce. This study therefore reports our experience with the novel silk vista baby (SVB) FDS and respective outcomes after eight and eleven months with special respect to specific adverse events.

Material and methods:
44 patients (mean age 53 years) harbouring 47 aneurysms treated with the SVB between June 2018 and December 2019 were included in our study. Clinical, procedural and angiographic data were collected. Follow-ups were performed on average after three, eight and eleven months, respectively. Treatment effect was assessed using the O´Kelly Marotta (OKM) grading system.

Results:
Overall, angiographic follow-ups were available for 41 patients / 45 aneurysms. Occlusion or significant reduction in aneurysmal perfusion (OKM: D1, B1-B3 and A2-3) was observed in 98% of all aneurysms after eight months. Only 2% of the treated aneurysms remained morphologically unaltered and without an apparent change in perfusion (OKM A1).
Adverse events in the early post-interventional course occurred in seven patients, out of them mRS-relevant morbidity at 90 days related to FDS treatment was observable in two patients. One death occurred in context of severe SAH related to an acutely ruptured dissecting aneurysm of the vertebral artery.

Conclusion:
The SVB achieves sufficient occlusion rates of intracranial aneurysms originating from peripheral segments, which are comparable to prior established conventional FDS with acceptably low complication rates. However, alteration of a hemodynamic equilibrium in distal localizations requires special attention to prevent ischemic events.