Silk Vista Baby for the treatment of distal anterior cerebral artery aneurysms.

IF 2.6 3区医学 Q2 CLINICAL NEUROLOGY

Neuroradiology Pub Date : 2025-08-01 Epub Date: 2025-07-02 DOI:10.1007/s00234-025-03678-y

Luca Scarcia, Frédéric Clarençon, Adam A Dmytriw, Eimad Shotar, Pascal Jabbour, Marios Psychogios, Peter Sporns, Ajit S Puri, Ameer E Hassan, Oktay Algin, Markus A Möhlenbruch, Riccardo Russo, Mauro Bergui, Oded Goren, Nourou Dine A Bankole, Gregoire Boulouis, Takeshi Morimoto, Raoul Pop, Joanna Wk Ho, Ángel Ferrario, Virginia Pujol Lereis, Jared Cooper, Giancarlo Salsano, Yan-Lin Li, Arturo Consoli, Alessandro Sgreccia, Eytan Raz, Charlotte Chung, Julien Burel, Chrysanthi Papagiannaki, Khawaja Muhammad Baqir Hassan, Hong Tao, Riitta Rautio, Matias Sinislao, Maria Ruggiero, Elvis Lafe, Valerio Da Ros, Luigi Bellini, Joseph Domenico Gabrieli, Francesco Causin, Michael Levitt, Antonio Armando Caragliano, Sergio Lucio Vinci, Guillaume Bellanger, Christophe Cognard, Gaultier Marnat, Lisa Saleille, Nicola Nimbucci, Francesco Capasso, Mariangela Piano, Claudia Rollo, Alexis Guedon, Andrea Romi, Fortunato Di Caterino, Alessandra Biondi, Firas Farhat, Mykola Vyval, Adrien Guenego, Thanh Nguyen, Mohamad Abdalkader, Ahmet Gunkan, Thibault Agripnidis, Maurizio Fuschi, Vitor Mendes Pereira, Andrea M Alexandre, Alessandro Pedicelli

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引用次数: 0

Abstract

Purpose: Treating small-caliber vessel aneurysms with flow diverters poses challenges due to narrow luminal diameters and tortuous vasculature, which complicate the navigation and deployment of conventional devices using standard microcatheters. The Silk Vista Baby (SVB, Balt, Montmorency, France) flow diverter was developed to treat intracranial aneurysms located in smaller vessels or more distal segments and is compatible with 0.017″ microcatheters. We present the largest multicenter analysis to date evaluating the outcomes of SVB use in unruptured distal anterior cerebral artery (DACA) aneurysms.

Methods: Retrospective data from 20 centers were reviewed for patients with unruptured DACA aneurysms treated with the SVB. Demographic information, clinical presentation, radiographic characteristics, complications, and outcomes were recorded.

Results: Seventy-nine patients (79 DACA aneurysms) were treated between January 2018 and December 2022; 59 were female (74.7%), and the median age was 61 years (IQR 53-67). Most aneurysms were saccular (89.9%), and 65.8% involved a branch. The median parent vessel diameter was 1.9 mm (IQR 1.7-2.1). A single stent was implanted in 97.5% of cases; 2.5% required two stents. The median imaging follow-up duration was 12 months (IQR 9.5-24). At the last follow-up, 76% of aneurysms showed complete or near-complete occlusion (O'Kelly-Marotta scale C or D, Raymond-Roy 1 or 2). Overall, thromboembolic or hemorrhagic complications occurred in 14% of patients, with two cases being symptomatic. The mortality rate was 0%, and the retreatment rate was 1.3%.

Conclusion: In this multicenter series, the SVB flow diverter represented a valuable treatment option for distal anterior cerebral artery (DACA) aneurysms.

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Silk Vista Baby用于治疗大脑前动脉远端动脉瘤。

目的：由于狭窄的管径和弯曲的血管，使用分流器治疗小口径血管动脉瘤带来了挑战，这使得使用标准微导管的传统设备的导航和部署复杂化。Silk Vista Baby （SVB, Balt, Montmorency, France）分流器用于治疗位于较小血管或较远段的颅内动脉瘤，并与0.017″微导管兼容。我们提出了迄今为止最大的多中心分析，评估SVB在未破裂的大脑前远动脉（DACA）动脉瘤中的应用结果。方法：回顾性分析来自20个中心的经SVB治疗的未破裂DACA动脉瘤患者的资料。记录人口统计信息、临床表现、影像学特征、并发症和结果。结果：2018年1月至2022年12月期间，79例患者（79例DACA动脉瘤）接受治疗；女性59例（74.7%），中位年龄61岁（IQR 53 ~ 67）。大多数动脉瘤呈囊状（89.9%），65.8%累及分支。母血管中位直径为1.9 mm （IQR为1.7-2.1）。单个支架置入率为97.5%；2.5%需要两个支架。中位影像学随访时间为12个月（IQR 9.5-24）。在最后一次随访中，76%的动脉瘤显示完全或接近完全闭塞（O'Kelly-Marotta评分C或D， Raymond-Roy评分1或2）。总体而言，14%的患者出现血栓栓塞或出血性并发症，其中2例有症状。死亡率为0%，再治疗率为1.3%。结论：在这个多中心研究中，SVB血流分流器是治疗大脑远前动脉（DACA）动脉瘤的一种有价值的治疗选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuroradiology 医学-核医学

CiteScore

5.30

自引率

3.60%

发文量

214

审稿时长

4-8 weeks

期刊介绍： Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.