The Silk Vista Baby Study: A multicenter aneurysm report from North America and Europe
Authors
Ricardo A. Hanel, Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA.
Otavio F. de Toledo, Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA.
Natalia V. De Oliveira Souza, Divisions of Therapeutic Neuroradiology and Neurosurgery, Neurovascular Centre, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Salvador F. Gutierrez-Aguirre, Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA.
Monika Killer-Oberpfalzer, Department of Neurology, Institute of Neurointervention, University Hospital Salzburg, Salzburg, Austria.
Eytan Raz, Department of Radiology and Neurosurgery, NYU Langone Health, New York, New York, USA.
Maksim Shapiro, Department of Radiology and Neurosurgery, NYU Langone Health, New York, New York, USA.
Tareq Kass-Hout, Department of Neurology, University of Chicago, Chicago, Illinois, USA.
Michael Hurley, Department of Radiology, University of Chicago, Chicago, Illinois, USA.
Rami Z. Morsi, Department of Neurology, University of Chicago, Chicago, Illinois, USA.
Visish M. Srinivasan, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Brian T. Jankowitz, Department of Neurosurgery, Penn Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Pierce Davis, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Adnan Siddiqui, Department of Neurosurgery, State University of New York at Buffalo, Buffalo, New York, USA.
Vinay Jaikumar, Department of Neurosurgery, State University of New York at Buffalo, Buffalo, New York, USA.
Gustavo M. Cortez, Department of Neurosurgery, State University of New York at Buffalo, Buffalo, New York, USA.
Omar Kass-Hout, Department of Neurology, University of North Carolina Rex Healthcare, Raleigh, North Carolina, USA.
Tibor Becske, Department of Neurology, University of North Carolina Rex Healthcare, Raleigh, North Carolina, USA.
Ramesh Grandhi, Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA.
Craig Kilburg, Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA.
Demetrius K. Lopes, Advocate Health - MidwestFollow
Andrew F. Ducruet, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Lucas Elijovich, Neurology, Semmes Murphey Clinic, Memphis, Tennessee, USA.
Gavin Britz, Department of Neurosurgery, Houston Methodist Hospital, Houston, Texas, USA.
Maria M. Toledo, Department of Neurosurgery, Ascension Sacred Heart Hospital, Pensacola, Florida, USA.
Joshua Seinfeld, Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado, USA.
Robert M. Starke, Department of Neurological Surgery, University of Miami School of Medicine, Miami, Florida, USA.
Raul G. Nogueira, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA.
Matthew T. Bender, Department of Neurosurgery, University of Rochester Medical Center, Rochester, New York, USA.
Peter T. Kan, Department of Neurological Surgery, University of Texas Medical Branch Galveston, Galveston, Texas, USA.
et al
Recommended Citation
Hanel RA, de Toledo OF, De Oliveira Souza NV, et al. The Silk Vista Baby Study: A Multicenter Aneurysm Report From North America and Europe. Neurosurgery. Published online July 10, 2025. doi:10.1227/neu.0000000000003611
Abstract
Background and objectives: The Silk Vista Baby (SVB) flow diverter (FD) stent (Balt SAS) is the first device designed for treating distally located brain aneurysms. It can be delivered through a 0.017-inch ID microcatheter, enabling access to small, distal vessels. The aim of this study was to evaluate the effectiveness, safety, technical success, occlusion rate, and clinical outcomes of the SVB device.
Methods: This retrospective, multicenter study included data from 18 centers from November 2023 to September 2024. Procedures were performed by experienced neurointerventionalists following institutional standards of care. Outcomes analyzed included effectiveness, safety, and aneurysm occlusion rates. Descriptive analyses and Pearson χ2 or Independent t-Test were used for statistical evaluation.
Results: A total of 95 patients, mean age 55.4 years, were included. A total of 31% of aneurysms were ruptured at admission. Most (58.3%) were located in the anterior circulation, and 45% had previous treatment, mainly coiling (69.4%). Complication rates were higher for ruptured aneurysms (24.1%) compared with unruptured ones (9.2%). Two deaths occurred, 1 (1.1%) related to the procedure. At discharge, 87% of patients had modified Rankin Scale ≤2. The latest follow-up showed overall complete/near-complete occlusion rates of 76.1%, with 81.14% for ruptured and 73.43% for unruptured aneurysms. Technical success was higher in unruptured cases (100% vs 93.1%).
Conclusion: Our case series demonstrated the efficacy of the SVB with a high rate of technical success. The occlusion rates for ruptured cases are comparable with those of other FDs. However, the rates are lower for unruptured cases. This discrepancy is likely due to the characteristics of the aneurysms, particularly in the presence of side branches in bifurcation lesions. The SVB safety profile is similar to other FDs in unruptured cases, while the ruptured group presented more complications.
