Silk Vista Baby demonstrates safety and effectiveness in PICA aneurysm treatment

Ricardo Hanel

Following a retrospective review of databases from multiple different centres, researchers have reported the safe and effective use of the Silk Vista Baby (Balt) flow diversion device in the treatment of complex posterior inferior cerebellar artery (PICA) aneurysms.

Writing in the journal Neurosurgery, Ricardo Hanel (Baptist Neurological Institute, Jacksonville, USA) and colleagues also state that, based on their findings, “the smaller delivery system profile reduces the risk of procedure complications and creates new treatment options for distal lesions”.

The authors begin by noting that the treatment of small-calibre vessel lesions using flow diverters “remains challenging” because of the vasculature’s narrow luminal diameter and tortuosity—which, in turn, makes navigation and delivery of conventional devices with standard microcatheters more difficult.

Owing to the fact the Silk Vista Baby flow diverter was designed for ease of use in vessels with a smaller diameter, in distal lesions, and with 0.017-inch microcatheter delivery systems, they set out to report outcomes associated with the device in the treatment of PICA aneurysms.

Hanel and colleagues detail that databases from different centres were retrospectively reviewed for PICA aneurysms treated with the device, with demographic information, clinical presentation, radiographic characteristics, procedural complications, and immediate postprocedural outcomes, all being obtained.

They report that 14 patients harbouring 15 true PICA aneurysms were treated between January 2019 and June 2021. Nine were female (64.2%), and the mean age was 51±14.9 years. Most patients had previously ruptured aneurysms, treated by another endovascular technique, the authors note. Six aneurysms were located distally (40%). The mean neck size was 3mm (standard deviation [SD] 1.35, range 2.5–5mm), whereas the mean PICA diameter was 1.6mm (SD 0.26, range 1.5–1.7mm). The mean length of follow-up was six months (SD 8.28, range 4.5–16 months), Hanel and colleagues also state.

Treatment-related adverse events observed in the review included one case of transient hypoesthesia. Two additional events were reported but—according to the authors—were adjudicated as having been unrelated to the procedure.

Complete occlusion, measured as Raymond-Roy class I, was achieved in all cases, leading Hanel and colleagues to conclude that the Silk Vista Baby device was safely and effectively used in the treatment of PICA aneurysms overall.


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