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Background: Flow-diverter technology has become an important stent-based embolization tool in the treatment of complex cerebrovascular pathology. We report here the experience of 4 Spanish centers with using the SILK flow-diverter (SFD) device., Objective: To evaluate the safety and efficacy of using the SFD in the endovascular treatment of intracranial aneurysms with complex morphology., Methods: We retrospectively examined a prospectively maintained database of patients treated with SFD devices between July 2008 and December 2013 at 1 of 4 institutions in Spain. Data regarding patient demographics, aneurysm characteristics, and technical procedure were analyzed. Angiographic and clinical findings were recorded during the procedure and at 12 months postoperatively., Results: A total of 175 SFD devices were implanted in 157 patients (women/men: 119/38; mean, median, and range of age: 56.2, 56.7, and 19-80 years, respectively), who were treated in a delayed manner (3-6 months from the event) for 180 aneurysms (165 unruptured and 15 ruptured). Adverse events (acute and delayed) were observed in 28.7% of cases (45/157), and most were resolved (19.1%; 30/157). Six months after the procedure, total morbidity and mortality were 9.6% (15/157) and 3.2% (5/157), respectively. Long-term imaging follow-up showed complete occlusion, neck remnants, and residual aneurysm in 78.1% (100/128), 14.0% (18/128), and 7.8% (10/128) of cases, respectively., Conclusions: The SFD device is an effective tool for the treatment of challenging aneurysms, and allows complete occlusion within a year of the procedure in most patients, with morbidity and mortality comparable to those previously reported for similar devices., (Copyright © 2016 by the Congress of Neurological Surgeons.)

Background and Purpose: Treatment of intracranial fusiform aneurysms is complex and controversial, and is associated with high morbidity and mortality rates. The goal of this study was to evaluate the strategy of stent only therapy., Materials and Methods: A retrospective analysis of 20 patients with 20 intracranial fusiform aneurysms undergoing endovascular treatment using stent only therapy was undertaken. Feasibility, safety, and angiographic follow-up were evaluated., Results: 28 Leo Plus stents were successfully deployed in 20 patients. No technical difficulties in relation to stent navigation, placement, or detachment from the delivery system were observed. A 6 month, 1 year, and 2 year follow-up angiograms were performed in all patients. 15 aneurysms showed complete occlusion and five partial stable occlusion. During the follow-up period, there was no evidence of in-stent stenoses or occlusion of the incorporated branching vessels. In this study, no patient presented with subarachnoid hemorrhage or died during follow-up., Conclusions: Stent only therapy in this study proved very useful as a flow diverter for the treatment of intracranial fusiform aneurysms in which parent artery occlusion or stenting-coiling was not feasible.

Treatment of acutely ruptured intracranial aneurysms in pregnancy represents a clinical challenge requiring a meticulously selected strategy. We report eight cases of ruptured cerebral aneurysms in eight pregnant patients treated safely and effectively via an endovascular approach.

We report initial experience with the use of a new intracranial stent, the Leo microstent in combination with detachable coils in treatment of patients with wide-necked cerebral aneurysms. The Leo stent represents a significant advance in the vascular treatment of intracranial aneurysm with high radial force and an easy delivery system. It is a feasible, secure, and effective system.

Background: Long-term follow-up of cerebral aneurysms treated with the Silk Vista Baby (SVB) flow diverter is lacking. This study aimed to assess the technical success, procedural safety, and efficacy of the SVB (Balt, Montmorency, France) for the treatment of intracranial aneurysms in small cerebral vessels over a midto long-term follow-up. Methods: We retrospectively analyzed a prospectively maintained database of patients treated with the SVB between September 2018 and June 2021. Data regarding patient demographics, aneurysm characteristics, and technical procedures were also collected. Angiographic and clinical findings were recorded during the procedure and over a period of at least 12  months. Results: Angiographic and clinical follow-up data were available for 50 patients/50 aneurysms. The procedural complication rate was 8%. At 12  months, the final results showed a technical success rate of 100%, the re rupture rate was 0%, neuromorbidity and mortality rates of 4 and 0%, respectively, and an almost complete occlusion rate of 94%. Conclusion: Treatment of complex intracranial aneurysms with the SVB was safe and effective. Long-term results showed high rates of adequate and stable occlusions. [ABSTRACT FROM AUTHOR]