LVIS Blue as a low porosity stent and coil adjuvant

Koch, Matthew J.; Stapleton, Christopher J.; Raymond, Scott B.; Williams, Susan; Leslie‐Mazwi, Thabele M; Rabinov, James D.

doi:10.1136/neurintsurg-2017-013608

Cited by 12 publications

(8 citation statements)

References 33 publications

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“…In the present study, although immediate angiographic results demonstrated a complete occlusion rate of 59%, progression to total occlusion was impressive with complete obliteration (86.4%) at the 1-year follow-up; morbidity or mortality did not occur. This result showed better angiographic and clinical outcomes than in previous studies on LVIS or LVIS Blue 11,18) .…”

Section: Discussionsupporting

confidence: 49%

“…The LVIS Blue, a new modification of LVIS, is a braided stent that provides a higher degree of metal coverage (approximately 28%) and is increasingly used for SAC. The LVIS Blue showed improved wall apposition and aneurysm neck coverage 11) and has a good crossing profile for microcatheters, better wall apposition and less perforator coverage than a flow redirection endoluminal device (FRED) 14) .…”

Section: Introductionmentioning

confidence: 99%

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Preliminary Experience of Lvis Blue in the Internal Carotid Artery for The Treatment Of Wide-Necked Intracranial Aneurysms

Kim

Jang

Lee

et al. 2019

J Neurointensive Care

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A new Low-profile Visualized Intraluminal Support device (LVIS Blue) is a braided stent that provides a higher degree of metal coverage and increasingly used for the stent-assisted coiling of intracranial aneurysms. In the present study, our preliminary experience of using LVIS Blue in the internal carotid artery (ICA) for the treatment of wide-necked intracranial aneurysms was reported. Methods This retrospective review included patients with ICA aneurysms prospectively collected from our database who were treated using LVIS Blue at our institution from September 2017 to December 2018. Angiographic results, clinical outcomes, and technical issues were evaluated. Results A total of 22 patients with unruptured wide-necked ICA aneurysms were treated using LVIS Blue. Seven aneurysms were located in the superior hypophyseal artery, 4 in posterior communicating artery, 4 in ICA dorsal wall, 3 in ICA bifurcation, 2 in ophthalmic artery, 1 in ICA ventral wall, and 1 in ICA lateral wall. During the procedure, suboptimal positioning and foreshortening of the stent occurred in 1 patient each. Immediate postembolization angiography showed complete obliteration in 13 patients (59.1%), residual neck in 4 (18.2%), and residual aneurysm in 5 patients (22.7%). Follow-up angiographic results showed complete obliteration in 19 patients (86.4%). In-stent stenosis (> 50% stenosis) was not observed on follow-up angiography. In addition, morbidity or mortality did not occur. Conclusion The LVIS Blue may be feasible and safe for stent-assisted coiling in ICA aneurysms. Foreshortening, suboptimal deployment, and difficulty to open proximal ends may be considerable technical issues in the tortuous ICA.

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Section: Discussionsupporting

confidence: 49%

Section: Introductionmentioning

confidence: 99%

Preliminary Experience of Lvis Blue in the Internal Carotid Artery for The Treatment Of Wide-Necked Intracranial Aneurysms

Kim

Jang

Lee

et al. 2019

J Neurointensive Care

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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%

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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“…Among these stents, the low-profile visualized intraluminal support (LVIS) stent (MicroVention, Tustin, California, USA) has the highest metal coverage ratio among commercial intracranial stents. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] As alternatives, flow diverter stents are a more recent and special type of intracranial stent, although the pipeline embolization device (PED) (Medtronic Neurovascular, Irvine, California, USA) is currently one of the most commonly used flow diverter stent in some countries. [15][16][17] Flow diverters significantly reduce the blood flow into aneurysms by "flow diversion," resulting in aneurysmal thrombosis.…”

Section: Introductionmentioning

confidence: 99%

Outcomes following aneurysmal coil embolization with intentionally shortened low-profile visible intraluminal support stent deployment

et al. 2021

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Purpose Among all stents available for neuroendovascular therapy, the low-profile visible intraluminal support stent bears the highest metal coverage ratio. We deployed a low-profile visible intraluminal support stent with a delivery wire or/and microcatheter system push action to shorten the low-profile visible intraluminal support stent and thus achieve a flow diversion effect. We report our single-institution experience with the use of low-profile visible intraluminal support stents for intentionally shortened deployment (shortening group) and non-shortened deployment (non-shortening group) for unruptured intracranial aneurysms. Methods We retrospectively reviewed the medical records of 130 patients with 131 intracranial aneurysms who were treated with low-profile visible intraluminal support stent-assisted coil embolization from February 2016–January 2019. All perioperative complications were noted. Every 6 months, we re-examined the patients with cerebral angiography or magnetic resonance angiography. The outcomes of aneurysm occlusion were evaluated by the modified Raymond–Roy occlusion classification. We used the finite element method and computational fluid dynamics to investigate the hemodynamics after shortened low-profile visible intraluminal support stent deployment. Results Immediately after treatment, the modified Raymond-Roy occlusion classification was significantly better in the shortening group than in the non-shortening group ( p<0.05). The latest angiographic outcomes showed the same tendency. Hemodynamic analysis by computational fluid dynamics suggested an adequate flow diversion effect with the use of our intentional shortening method. Conclusions Stent-assisted coil embolization using this technique showed good results of a high complete occlusion rate and low complication rate. These findings suggest that shortened low-profile visible intraluminal support stent deployment yields a flow diversion effect and may lead to early intra-aneurysmal thrombus formation.

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LVIS Blue as a low porosity stent and coil adjuvant

Abstract: The LVIS Blue represents a safe option as a coil adjunct for endovascular embolization within both the proximal and distal anterior and posterior circulation.

Cited by 12 publications

References 33 publications

Preliminary Experience of Lvis Blue in the Internal Carotid Artery for The Treatment Of Wide-Necked Intracranial Aneurysms

Preliminary Experience of Lvis Blue in the Internal Carotid Artery for The Treatment Of Wide-Necked Intracranial Aneurysms

Stent-Assisted Coiling Using Leo+ Baby Stent

Outcomes following aneurysmal coil embolization with intentionally shortened low-profile visible intraluminal support stent deployment

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