Delayed Foreshortening and Prolapse of Silk Vista Baby into Superior Cerebellar Artery Aneurysm.

Aneurysm Angiography Flow diverter Technique

Journal

World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275

Informations de publication

Date de publication:
11 Oct 2023
Historique:
received: 23 06 2023
revised: 04 10 2023
accepted: 05 10 2023
pubmed: 14 10 2023
medline: 14 10 2023
entrez: 13 10 2023
Statut: aheadofprint

Résumé

Flow diversion has evolved as a minimally invasive treatment for intracranial aneurysms. The Silk Vista Baby (SVB) can be navigated into small cerebral vessels because it can be deployed through a low-profile microcatheter. We report on treating a patient in his 70s with an unruptured fusiform right superior cerebellar artery aneurysm using an SVB. Significant foreshortening of the device was noted during the initial procedure; however, the position was satisfactory with good apposition and clearance of the aneurysm neck. A stable position of the SVB on 1-day and 2-month postprocedural computed tomography angiography was also demonstrated. Subsequently, a 6-month follow-up computed tomography angiography detected delayed foreshortening and prolapse of the SVB into the aneurysm, for which an additional SVB was placed in a second procedure. There were no complications and the patient remained clinically well. Although the intraoperative foreshortening was not unexpected, the delayed postprocedural behavior of proximal foreshortening and subsequent prolapse of the SVB into the aneurysm have not been previously described. We would like to share this for awareness in this technical note.

Sections du résumé

BACKGROUND BACKGROUND
Flow diversion has evolved as a minimally invasive treatment for intracranial aneurysms. The Silk Vista Baby (SVB) can be navigated into small cerebral vessels because it can be deployed through a low-profile microcatheter.
METHODS METHODS
We report on treating a patient in his 70s with an unruptured fusiform right superior cerebellar artery aneurysm using an SVB.
RESULTS RESULTS
Significant foreshortening of the device was noted during the initial procedure; however, the position was satisfactory with good apposition and clearance of the aneurysm neck. A stable position of the SVB on 1-day and 2-month postprocedural computed tomography angiography was also demonstrated. Subsequently, a 6-month follow-up computed tomography angiography detected delayed foreshortening and prolapse of the SVB into the aneurysm, for which an additional SVB was placed in a second procedure. There were no complications and the patient remained clinically well.
CONCLUSIONS CONCLUSIONS
Although the intraoperative foreshortening was not unexpected, the delayed postprocedural behavior of proximal foreshortening and subsequent prolapse of the SVB into the aneurysm have not been previously described. We would like to share this for awareness in this technical note.

Identifiants

pubmed: 37832636
pii: S1878-8750(23)01430-4
doi: 10.1016/j.wneu.2023.10.026
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

13-18

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Auteurs

Eef J Hendriks (EJ)

Division of Neuroradiology, University Medical Imaging Toronto & Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada. Electronic address: eef.hendriks@uhn.ca.

Felipe Guardini (F)

Division of Neuroradiology, University Medical Imaging Toronto & Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.

Emily Chung (E)

Division of Neuroradiology, University Medical Imaging Toronto & Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.

Jeremy Lynch (J)

Division of Neuroradiology, University Medical Imaging Toronto & Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.

Timo Krings (T)

Division of Neuroradiology, University Medical Imaging Toronto & Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada; Department of Surgery, Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.

Classifications MeSH