Treatment of recurrent cerebral bifurcation aneurysms using flow diverter stent silk vista: A monocentric case series

Objective To evaluate the efficacy and safety of the Silk Vista flow diverter stent in treating recurrent cerebral bifurcation aneurysms, highlighting angiographic and clinical outcomes in a monocentric case series. Methods A retrospective analysis of 12 patients (7 male, five female) with recurrent bifurcation aneurysms treated exclusively with the Silk Vista flow diverter was conducted. Aneurysms were located in the anterior communicating artery (75%), middle cerebral artery (17%), and basilar artery (8%). All patients received dual antiplatelet therapy for ten days pre-procedure and 6 months post-procedure, followed by aspirin monotherapy. The O’Kelly-Marotta (OKM) scale was used to assess aneurysm filling, where Grade D indicates complete occlusion. Clinical outcomes were measured using the modified Rankin Scale (mRS), with scores of 0–1 reflecting no or minimal disability. Results At the end of the procedure, 75% ( n = 9) of patients exhibited stagnant contrast filling within the aneurysm sac (OKM Grade C) during the venous phase. Periprocedural thromboembolic complications occurred in 17% ( n = 2) of cases, without clinical sequelae. No post-hospital complications were observed, and all patients maintained mRS scores of 0–1 at discharge. At 1-year follow-up, complete aneurysm exclusion (OKM Grade D) was achieved in 83% ( n = 10), while minimal neck perfusion (OKM Grade C) persisted in 17% ( n = 2). No new neurological deficits or deterioration occurred. Conclusion Despite the small sample size and single-center design, the Silk Vista flow diverter demonstrated favorable angiographic and clinical outcomes, supporting its role as a viable and safe option in this complex patient population.