Assisted coiling using LEO Baby or LVIS Jr stents: Report of six cases

Negrotto, Matías; Crosa, Roberto; Casagrande, Walter

doi:10.1177/1591019915590098

Cited by 16 publications

(6 citation statements)

References 24 publications

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“…3 ). An explanation is the higher metal coverage (smaller cell size) of the Leo+ Baby compared to other laser-cut and braided MSs—although it is still not comparable to typical FDSs [ 3 , 19 ]. A smaller cell size works as a more effective scaffold for endothelial growth leading to a progressive sealing of the aneurysm neck [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the last decade the possibilities for endovascular treatment of cerebral aneurysms (CA) have been considerably extended and studies have proved lower morbidity and mortality for coiling than for surgical clipping [ 1 , 2 ]; however, many aneurysms are still challenging to treat, especially if very small, wide neck, located at a bifurcation or at distant parent vessels [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Stent-Assisted Coiling Using Leo+ Baby Stent

et al. 2020

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Background Stent-assisted coiling is well-established for treatment of cerebral aneurysms. The technique enables treatment of wide-neck, bifurcation and recurrent aneurysms with high packing rates. While described in extenso for laser cut stents, the results of patients treated with the Leo+ Baby (Balt, Montmorency, France) braided microstent are presented. Material and Methods Patients were included if treated with a Leo+ Baby and with digital subtraction angiography (DSA) follow-up available of at least 6 months. Data were evaluated for successful deployment, aneurysm occlusion according to the modified Raymond-Roy classification (MRRC), stent patency and procedure-related morbidity and mortality. Results A total of 81 patients were included and Leo+ Baby deployment was successful in all cases. Coils were used in 80 cases. In 1 case 2 stents were used stent-in-stent without additional coiling. Initial aneurysm occlusion rates were MRRCi1 51.9%, MRRCi2 11.1%, MRRCi3a 24.7% and MRRCi3b 12.3%. Occlusion rates after 6 months were MRRC6m1 78.9%, MRRC6m2 3.9%, MRRC6m3a 6.6% and MRRC6m3b 10.5%. Procedure-related morbidity was 1 case of acute stent thrombosis successfully treated with tirofiban and 1 case with transient hemiparesis due to stent thrombosis after 4 months. There was 1 case of coil-associated subarachnoid hemorrhage (SAH) which caused prolonged hospitalization. No procedure-related mortality was observed. Conclusion The results confirm that stent-assisted coiling with the Leo+ Baby stent is safe and efficient for treatment of wide neck or recurrent cerebral aneurysms. Spontaneous progressive aneurysm occlusion over 6 months supports the theory of considerable flow-modulating effects of Leo+ Baby.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Stent-Assisted Coiling Using Leo+ Baby Stent

et al. 2020

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“…The low-profile visualized intraluminal support (LVIS; MicroVention, Aliso Vajo, USA) device is a braided and self-expanding device, which has been used to treat broad-neck, complex cerebral aneurysms [1][2][3][4][5][6][7][8][9][10][11][12][13]. In a systematic review of the use of braided stents in early studies (2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017) involving 35 studies comprising 1426 patients [14], the overall successful stent delivery and complete aneurysm occlusion rates were 97% and 88.3%, respectively.…”

Section: Introductionmentioning

confidence: 99%

Small ruptured and unruptured complex cerebral aneurysms: Single center experience of low-profile visualized intraluminal support stent

Lv¹,

Jiang²,

Liang³

2019

Journal of Neurorestoratology

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Objectives:Even though low-profile visualized intraluminal support (LVIS) device is used extensively currently and provide intraluminal support in complex cerebral aneurysm embolization, only few studies have reported its clinical results. This study presents the results of patients treated with LVIS.Patients and methods:Cerebral aneurysms with an undefined neck, fusiform shape, and blood blister-like aneurysms that were treated with LVIS between May 2017 and May 2019 were reviewed retrospectively.Results:Overall, 112 aneurysms in 104 patients were treated using LVIS, and 105 LVISs were placed. Of these, 101 aneurysms (90%) were small (< 10 mm) in size, 17 were fusiform aneurysms, and 3 were blood blister-like aneurysms. Overall, 39 patients suffered a subarachnoid hemorrhage and 65 had no bleeding history. 2 patients died of internal carotid artery (ICA) thrombosis, resulting in 1.9% mortality rate. Follow-up angiography was obtained in 68 patients (65%), and the complete obliteration rate was 98.5% in 6–12 months.Conclusion:The LVIS is a safe and effective treatment for small ruptured or unruptured complex intracranial aneurysms.

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“…Later, flow-diverting SILK and Pipeline devices were used, primarily in the setting of ICA blister aneurysms [ 6 , 7 ]. The braided stents LVIS and Leo [ 8 ] were also used in this cohort. Until recently, LVIS Jr and LEO + baby were the smallest stents available, and both are compatible with standard 0.017″ coiling microcatheters such as Excelsior SL10 and Echelon 10.…”

Section: Discussionmentioning

confidence: 99%

Stent placement in patients with acute subarachnoid haemorrhage: when is it justified?

et al. 2018

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PurposeEndovascular stents are widely used for the elective treatment of cerebral aneurysms. Acute stenting is performed in the management of dissections, pseudo-aneurysms, broad-based aneurysms or as a ‘bail out’ measure after coil migration. The purpose of this study is to review the safety of using stents in acute subarachnoid haemorrhage.MethodsThe stent registry of our institution was reviewed for procedures in patients with acute subarachnoid haemorrhage. Imaging studies were reviewed on the hospital’s PACS system and the patients’ notes were retrieved to assess complications and clinical outcomes. Procedures were analysed according to the type of stent, treatment indication, antiplatelet regime, complications and outcomes.ResultsBetween 2008 and 2016, 51 stents were placed during 50 stenting procedures in 49 patients with acute subarachnoid haemorrhage. This included 24 patients with saccular aneurysms, 10 with blister aneurysms, 10 dissections and five fusiform aneurysms. Stents were deployed in ‘bail out’ situations on eight occasions. In six cases, flow-diverting stents were used. Eighteen patients (37%) in the cohort suffered a stroke. Nine patients (18%) suffered persistent clinical deficits as a result of the stenting procedure, all but one of which occurred within 24 h. Two patients had a transient ischaemic episode, and there was evidence of asymptomatic ischaemia on imaging in four cases (8%). Five patients died, three (6%) as a result of procedural complications. Twelve patients (25%) required a further embolisation procedure.ConclusionThe use of stents in acute subarachnoid haemorrhage incurs a considerable complication risk and should be reserved for exceptional circumstances.

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Assisted coiling using LEO Baby or LVIS Jr stents: Report of six cases

Cited by 16 publications

References 24 publications

Stent-Assisted Coiling Using Leo+ Baby Stent

Stent-Assisted Coiling Using Leo+ Baby Stent

Small ruptured and unruptured complex cerebral aneurysms: Single center experience of low-profile visualized intraluminal support stent

Stent placement in patients with acute subarachnoid haemorrhage: when is it justified?

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