Endovascular treatment of intracranial aneurysms with the LVIS device: a systematic review

BackgroundBifurcation aneurysms can be treated with stent-assisted coiling using two stents in a Y-configuration. We aim to investigate the angiographic and clinical outcomes of Y-stent constructs for the treatment of intracranial aneurysms.MethodsA systematic review of PubMed, Ovid MEDLINE, and Ovid EMBASE databases was conducted based on PRISMA guidelines. The study selection was performed using the ‘Ryyan’ application. Our analysis included 18 studies with 327 patients. Inclusion criteria were: articles published from January 2000 to November 2017, English language, including cerebral aneurysms treated via Y-stenting, and ≥5 cases with radiographic/clinical outcomes. Technical notes, editorials, reviews, and animal studies were excluded. A random-effect meta-analysis was performed on angiographic and clinical outcomes, including aneurysm occlusion, modified Rankin Scale, neurological outcome, and procedure-related mortality. 95% CIs and event rates were estimated. Statistical heterogeneity was assessed using I2 statistics.ResultsThe procedure-related good outcome rate was 92% and complete occlusion rate was 91%. The permanent neurological deficit rate was 4% and procedure-related mortality was 2%. The procedure-related stroke rate was 12%. A total of 28/146 (19%) patients had ruptured aneurysms. At long-term follow-up, overall stroke rate was 9% in patients with unruptured aneurysm. The mortality rate was higher in cases with ruptured aneurysms than in those with unruptured aneurysms (18% vs 0.8%; p<0.001).ConclusionsY-stenting for bifurcation aneurysms yields a high rate of complete occlusion and low rates of mortality and stroke. Careful patient selection is needed.

Section: Discussionmentioning

confidence: 77%

Stent-assisted coiling of cerebral aneurysms using the Y-stenting technique: a systematic review and meta-analysis

Granja

Cortez

Aguilar‐Salinas

et al. 2019

“…Similarly, for the Leo baby stent, the reported morbidity and mortality rates were 3.8% and 0%, respectively 13. The incidence of morbidity and mortality were 2.8% and 2% for the Enterprise stent14 and 1.4% and 0% for the LVIS stent, respectively 19…”

Section: Discussionmentioning

confidence: 94%

The Neuroform Atlas stent to assist coil embolization of intracranial aneurysms: a multicentre experience

Ulfert

Pham

Sonnberger

et al. 2018

“…In a smaller number of patients when LVIS Jr ‘C’ was used, the technical success was also 100% in the previous series,13 possibly owing to the improved radial force in LVIS Jr ‘C’ stents. A systematic review of all LVIS stents showed technical success of 96.8% 14. The technical success rates have been reported to be 94% with Neuroform,7 95% with Enterprise stents,5 and 100% with Solitaire stents 9…”

Section: Discussionmentioning

confidence: 99%

“…A systemic review of the use of LVIS stents reported a thromboembolic rate of 4.9% and hemorrhagic complication rate of 2.1% 14. Mocco et al 5 reported 2.8% permanent morbidity and 2% mortality associated with use of Enterprise stents.…”

Section: Discussionmentioning

confidence: 99%

Canadian Registry of LVIS Jr for Treatment of Intracranial Aneurysms (CaRLA)

Shankar

Quateen

Weill

et al. 2016