Tapered Flow Diverters in the Treatment of Intracranial Aneurysms

Abstract

AIM:To report the initial experience of cerebral aneurysm treatment with Tapered flow diverters (TFDs). MATERIAL AND METHODS: Thirty patients with 34 aneurysms underwent cerebral aneurysm treatment with TFD (Silk, Balt, Montmorency, France) between March 2011 and March 2016. Procedural findings, complications, clinical and imaging follow-up were assessed retrospectively. RESULTS: The patients" mean age was 48 +/- 14.5 years (range, 16-74; 25 females). Aneurysms size ranged from 3 to 35 mm with an average diameter of 13.9 +/- 8.8 mm and a median diameter of 10.5 mm. Technical success rate was 96.6%. Technically, deployment of the device was similar to the non-tapered version and subjectively, it appeared to be easier in the paraophthalmic segment. Permanent morbidity and mortality rates secondary to the procedure were 0%. On clinical follow-up (29 patients, mean 9.3 +/- 9.1 months) there were no clinical untoward events. Imaging follow-up was at or after 6 months (20 patients, mean 12.3 +/- 10 months). Angiographic occlusion rate was 80%. CONCLUSION: TFD is safe to use and effective for the treatment of intracranial aneurysms in this series. The occlusion rate is higher with respect to the previous reports and experience using the non-tapered version. Maintenance of porosity at the transition zone may be the factor underlying the higher occlusion rate. TFD may be preferred especially for arterial segments aneurysms where there is considerable discrepancy in size between the distal and proximal parent artery.