Distal Flow Diversion with Anti-Thrombotically Coated and Bare Metal Low-Profile Flow Diverters-A Comparison

Area of Science:

• Neurosurgery
• Endovascular Therapy
• Medical Devices

Background:

• Low-profile flow diverting stents (FDS) have advanced endovascular treatment for peripheral cerebral aneurysms.
• Key devices include the Silk Vista Baby (SVB) and the p48MW HPC.

Purpose of the Study:

• To compare the performance and outcomes of SVB and p48MW HPC.
• To specifically evaluate hemodynamic aspects in peripheral segments and bifurcations.

Main Methods:

• A cohort of 108 patients treated between June 2018 and April 2021.
• Patients received either SVB (60) or p48MW HPC (48).
• Hemodynamic assessment using the O.K.M. classification at immediate and follow-up stages.

Main Results:

• p48MW HPC achieved greater immediate hemodynamic downgrading (75.1%) compared to SVB (60%).
• SVB demonstrated higher rates of complete occlusion (OKM D1: 64.4%) at follow-up versus p48MW HPC (27.3%).
• Adverse events with neurologic sequelae were comparable (5.0% vs. 4.2%).

Conclusions:

• The p48MW HPC exerted a more significant immediate hemodynamic effect.
• The uncoated SVB facilitated earlier complete occlusion of aneurysms.
• Both devices offer comparable safety profiles for treating peripheral cerebral aneurysms.