Italian multicenter experience with flow-diverter devices for intracranial unruptured aneurysm treatment with periprocedural complications—a retrospective data analysis

Introduction
We report the experiences of 25 Italian centers,
analyzing intra- and periprocedural complications of endovascular treatment of intracranial aneurysms using Silk (Balt Extrusion, Montmorency, France) and pipeline embolization devices (EV3 Inc, Irvine California).
Methods
Two hundred seventy-three patients with 295 cerebral
aneurysms, enrolled in 25 centers in Italy and treated
with the new flow-diverter devices, were evaluated; 142
patients were treated with Silk and 130 with pipeline (in
one case, both devices were used). In 14 (5.2 %) cases
devices were used with coils. Aneurysm size was >15 mm
in 46.9 %, 5–15 mm in 42.2 %, and <5 mm in 10.8 %.
Aneurysm locations were supraclinoid internal carotid artery
(ICA) in 163 cases (55.2 %), cavernous ICA in 76
(25.7 %), middle cerebral artery in 11 (3.7 %), PCoA in 6
(2 %), and ACoA in 2 (0.7 %); the vertebrobasilar system
accounted for 32 cases (10.8 %) and PCA in 5 (1.7 %).
Results
Technical adverse events occurred with 59 patients
(21.6 %); 5 patients died after ischemic events, 10 to hemorrhagic complications, and 1 from external ventricular
drain positioning. At 1 month, morbidity and mortality rates
were 3.7 % and 5.9 %, respectively
Conclusion
Our retrospective study confirms that morbidity
and mortality rates in treatment with FDD of unruptured
wide-neck or untreatable cerebral aneurysms do not differ
from those reported in the largest series.