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.