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

Abstract

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.