Endovascular Treatment of Ruptured Wide-Necked Anterior Communicating Artery Aneurysms Using a Low-Profile Visualized Intraluminal Support (LVIS) Device

Xue, Gaici; Liu, Peng; Xu, Feifei; Fang, Yibin; Li, Qiang; Hong, Bo; Xu, Yi; Liu, Jianmin; Huang, Qinghai

doi:10.3389/fneur.2020.611875

Cited by 3 publications

(2 citation statements)

References 30 publications

(35 reference statements)

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“…Moreover, for aneurysms located in small arteries with small and tortuous parent artery, the procedure could lead to a higher incidence of thromboembolic events. 5 Xue et al 7 reported 31 acutely ruptured wide-necked anterior communicating artery aneurysms treated with LVIS stent. Intraoperative thrombosis and postoperative aneurysmal rebleeding occurred in 1 case each (3.2%).…”

Section: Discussionmentioning

confidence: 99%

Predictors of Perioperative Complications During Leo Baby Stent Treatment for Acutely Ruptured Intracranial Aneurysms: A Retrospective Multicenter Study

Yan,

Feng,

Liu

et al. 2023

Neurosurgery

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BACKGROUND AND OBJECTIVES: Stent-assisted coiling (SAC) of acutely ruptured aneurysms has been controversial. Moreover, for aneurysms originating from small diameter vessels, the SAC presents more challenges. This study aimed to investigate the predictors of perioperative complications after SAC with Leo baby stent of acutely ruptured aneurysms. METHODS: We performed a retrospective multicenter analysis of 425 patients with acutely ruptured aneurysms treated with Leo baby. We compared clinical characteristics and outcomes among patients with perioperative complications and those without. Subgroup analysis, including thromboembolic and hemorrhagic complications, was also performed. RESULTS: Immediate postoperative angiograms showed Raymond 1 in 357 aneurysms (84.2%), 2 in 53 (12.5%), and 3 in 14 (3.3%). A total of 372 patients (87.5%) were independent (modified Rankin Scale [mRS] score 0-2) at discharge. Perioperative complications occurred in 18 cases (4.2%) harboring 13 cases (3.1%) of thromboembolic complications and 5 cases (1.2%) of hemorrhagic complications. Patients with perioperative complications had a higher rate of unfavorable outcomes at discharge (P = .018), especially with thromboembolic complications (P = .043). Multivariate analysis showed that higher preoperative mRS score (P = .004), irregular shape (P = .017), and larger aneurysms (P = .049) were independent predictors of the overall complications, whereas higher preoperative mRS score (P = .022) was an independent predictor for ischemic complications. The follow-up angiogram was available for 245 patients, and the follow-up angiograms revealed Raymond 1 in 223 aneurysms (91.0%), 2 in 19 (7.8%), and 3 in 3 (1.2%). CONCLUSION: Worse clinical condition, irregular shape, and larger aneurysms were independently associated with overall complications, whereas worse clinical condition was viewed as an independent predictor for thromboembolic complications. Attention to these factors is essential for the safe treatment and prognosis of patients with acutely ruptured aneurysms.

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Section: Discussionmentioning

confidence: 99%

Predictors of Perioperative Complications During Leo Baby Stent Treatment for Acutely Ruptured Intracranial Aneurysms: A Retrospective Multicenter Study

Yan,

Feng,

Liu

et al. 2023

Neurosurgery

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“…After deployment of the first coil, an initial bolus of 50 U/kg heparin was given, and the activated clotting time was maintained at two times the normal range. For wide-neck aneurysms, ( 14 ) coiling with a stent or a balloon was performed by interventionalists with 20 years of experience at each center. During the procedure of stent-assisted coiling, patients would be allocated 300 mg clopidogrel and 300 mg aspirin.…”

Section: Methodsmentioning

confidence: 99%

Independent predictors and risk score for intraprocedural rupture during endovascular treatment of small ruptured intracranial aneurysms (<5 mm)

Peng

Feng²,

He³

et al. 2022

Front. Neurol.

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Background and purposeIntraprocedural rupture (IPR) is a devastating complication of endovascular treatment (EVT). Small-sized and ruptured aneurysms are independent predictors of IPR, which presents a technical challenge during EVT. We aimed to develop a score to quantify the individual patient risk of IPR in the EVT of small (<5 mm) ruptured aneurysms (SRAs).MethodsA retrospective review was conducted to interrogate databases prospectively maintained at two academic institutions in China from January 2009 to October 2016. We collected intraoperative angiograms and medical records to identify independent predictors of IPR using univariate and multivariable analyses. A risk score for IPR was derived using multivariable logistic regression analyses.ResultsOf the 290 enrolled patients, IPR occurred in 16 patients (5.5%). The univariate analysis showed that the rate of IPR was significantly higher in patients having aneurysms with a small basal outpouching (SBO), in patients having aneurysms concomitant with adjacent moderate atherosclerotic stenosis (ACAMAS), and in former or current smokers. Multivariate analyses showed that SBO [odds ratio (OR): 3.573; 95% confidence interval (CI): 1.078–11.840; p = 0.037], vascular eloquence (VE; OR: 3.780; 95% CI: 1.080–13.224; p = 0.037), and ACAMAS (OR: 6.086; 95% CI: 1.768–20.955; p = 0.004) were significantly and independently associated with IPR. A three-point risk score (S-V-A) was derived to predict IPR [SBO (yes = 1), VE (yes = 1), and ACAMAS (yes = 1)].ConclusionsIntraprocedural rupture occurred in 5.5% of the patients during EVT of SRA. SBO, VE, and ACAMAS were independent risk factors of IPR in the EVT of SRA. Based on these variables, the S-V-A score may be useful in predicting IPR daily, but more confirmation studies are required.

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Intra-procedural complications, success rate, and need for retreatment of endovascular treatments in anterior communicating artery aneurysms: a systematic review and meta-analysis

et al. 2022

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Endovascular Treatment of Ruptured Wide-Necked Anterior Communicating Artery Aneurysms Using a Low-Profile Visualized Intraluminal Support (LVIS) Device

Cited by 3 publications

References 30 publications

Predictors of Perioperative Complications During Leo Baby Stent Treatment for Acutely Ruptured Intracranial Aneurysms: A Retrospective Multicenter Study

Predictors of Perioperative Complications During Leo Baby Stent Treatment for Acutely Ruptured Intracranial Aneurysms: A Retrospective Multicenter Study

Independent predictors and risk score for intraprocedural rupture during endovascular treatment of small ruptured intracranial aneurysms (<5 mm)

Intra-procedural complications, success rate, and need for retreatment of endovascular treatments in anterior communicating artery aneurysms: a systematic review and meta-analysis

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