GATA Haydarpasa Teaching Hospital Department of Radiology, Istanbul, Turkey.
Neuroradiology. 2012 Dec;54(12):1355-65. doi: 10.1007/s00234-012-1051-7. Epub 2012 Jun 14.
Endovascular treatment of intracranial aneurysms has been an effective treatment option. In this paper, we report our experience with the Silk stent (SS) for endovascular treatment of complex intracranial aneurysms and present periprocedural events, immediate results, delayed complications, and imaging and clinical follow-up results.
We retrospectively examined angiographic images and clinical reports of 76 consecutive patients with 87 intracranial aneurysms who were treated with SSs between March 2008 and June 2011.
All aneurysms could be successfully covered technically using implanted SSs, with an overall mortality of 6.6 %. Two transient morbidities (2.6 %) and three permanent morbidities due to embolic events (3.9 %) were observed. Unexpected procedural technical events occurred in 18 procedures (18/78, 23.1 %). Control angiographies were performed in all 71 patients with 82 aneurysms (100 %). Mean angiographic follow-up time was 17.5 ± 11.1 months [range 2-48 months]. Sixteen of the 71 patients with 19 aneurysms had only early angiographic controls in the first 6 months while remaining 55 patients with 63 aneurysms (77.5 %) had late controls after 6 months. Overall control angiographic occlusion rates were as follows: 87.8 % (72/82) total occlusion, 8.5 % residual aneurysm filling, and 3.7 % residual neck filling. The general in-stent stenosis rate in controls was 5.6 % and the stented parent artery occlusion rate was 4.2 %. Five (6.6 %) aneurysms ruptured after stent implantation in our series.
The Silk stent is an effective tool for the treatment of challenging aneurysms, which have previously demonstrated higher re-growth rates and technical problems, despite unexpected higher hemorrhage rates after treatment and deployment difficulties.
颅内动脉瘤的血管内治疗一直是一种有效的治疗选择。本文报告了我们使用 Silk 支架（SS）治疗复杂颅内动脉瘤的经验，并介绍了围手术期事件、即刻结果、迟发性并发症、影像学和临床随访结果。
我们回顾性分析了 2008 年 3 月至 2011 年 6 月期间使用 SS 治疗的 76 例 87 个颅内动脉瘤患者的血管造影图像和临床报告。
所有动脉瘤均能成功地通过植入 SS 进行技术覆盖，总死亡率为 6.6%。观察到 2 例短暂性并发症（2.6%）和 3 例因栓塞事件导致的永久性并发症（3.9%）。18 例（18/78，23.1%）发生了意外的手术技术事件。所有 71 例 82 个动脉瘤患者均进行了血管造影控制检查（100%）。平均血管造影随访时间为 17.5±11.1 个月（范围 2-48 个月）。71 例患者中的 19 个动脉瘤仅在早期 6 个月进行了早期血管造影控制，而其余 55 例患者中的 63 个动脉瘤（77.5%）在 6 个月后进行了晚期控制。总的血管造影闭塞率如下：87.8%（72/82）完全闭塞，8.5%残留动脉瘤充盈，3.7%残留颈部充盈。在控制中支架内狭窄率一般为 5.6%，支架母动脉闭塞率为 4.2%。在我们的研究中，5 个（6.6%）动脉瘤在支架植入后破裂。
Silk 支架是一种治疗具有挑战性的动脉瘤的有效工具，这些动脉瘤之前表现出更高的再生长率和技术问题，尽管治疗和部署后出血率更高，且存在部署困难。
