Silk Vista Baby for the treatment of complex posterior inferior cerebellar artery aneurysms

Authors

Victor H. Benalia, Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA.Follow
Gustavo M. Cortez, Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA.Follow
Leonardo B. Brasiliense, Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA.
Robert M. Starke, Department of Neurological Surgery, University of Miami School of Medicine, Miami, Florida, USA.
Monika Killer-Oberpfalzer, Institute of Neurointervention/Department of Neurology, University Hospital Salzburg, Salzburg, Austria.
Demetrius K. Lopes, Advocate Aurora HealthFollow
Peter T. Kan, Department of Neurosurgery, University of Texas Medical Branch, Galveston, Texas, USA.
Raul G. Nogueira, Neuroendovascular Service Marcus Stroke & Neuroscience Center, Grady Memorial Hospital, Atlanta, Georgia, USA.
Jeremiah N. Johnson, Department of Neurosurgery, University of California, Los Angeles, California, USA.
Vitor M. Pereira, Division of Neurosurgery, Departments of Surgery and Medical Imaging, St Michaels Hospital, University of Toronto, Toronto, Ontario, Canada.
Craig Kilburg, Neurosurgery Department, University of Utah Health, Salt Lake City, Utah, USA.
Susan Khalili, Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA.
Ricardo A. Hanel, Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA.

Recommended Citation

Benalia VHC, Cortez GM, Brasiliense LBC, et al. Silk Vista Baby for the Treatment of Complex Posterior Inferior Cerebellar Artery Aneurysms. Neurosurgery. 2022;91(4):547-554. doi:10.1227/neu.0000000000002072

Affiliations

Brain and Spine Institute, Advocate Aurora Health

Abstract

Background: Treatment of small-caliber vessel lesions using flow diverters remains challenging because of vasculature's narrow luminal diameter and tortuosity. This in turn makes navigation and delivery of conventional devices with standard microcatheters more difficult. The Silk Vista Baby (SVB, Balt) flow diversion device was designed for ease of use in vessels with a smaller diameter, distal lesions, and 0.017″ microcatheter delivery systems.

Objective: To report the outcomes of the SVB device on the treatment of posterior inferior cerebellar artery (PICA) aneurysms.

Methods: Databases from different centers were retrospectively reviewed for PICA aneurysms treated with SVB. Demographic information, clinical presentation, radiographic characteristics, procedural complications, and immediate postprocedure outcomes were obtained.

Results: Fourteen patients harboring 15 true PICA aneurysms were treated between January 2019 and June 2021. Nine were female (n = 9/14; 64.2%), and the mean age was 51 ± 14.9 years. Most patients had previously ruptured aneurysms, treated by another endovascular technique. Six aneurysms were located distally (n = 6/15; 40%). The mean neck size was 3 mm (SD 1.35, range 2.5-5 mm), whereas the mean PICA diameter was 1.6 mm (SD 0.26, range 1.5-1.7 mm). The mean length of follow-up was 6 months (SD 8.28, range 4.5-16 months). Treatment-related adverse events included 1 case of transient hypoesthesia. Two additional events were reported, but adjudicated as unrelated to the procedure. Complete occlusion, measured as Raymond-Roy class I, was achieved in all cases.

Conclusion: The SVB device was safely and effectively used in the treatment of PICA aneurysms. The smaller delivery system profile reduces the risk of procedure complications and creates new treatment options for distal lesions.

Document Type

Article

PubMed ID

35830269