Utility of low-profile visualized intraluminal support (LVIS™) stent for treatment of acutely ruptured bifurcation aneurysms: A single-center study

Abstract

ObjectiveStent-assisted coiling has been increasingly used in the treatment of intracranial aneurysms. However, its application in ruptured bifurcation aneurysms remains controversial and challenging. This study aimed to present the safety and feasibility of low-profile visualized intraluminal support (LVIS™, LVIS, and LVIS Jr.) stent for acutely ruptured bifurcation aneurysms.MethodsA total of 41 patients with acutely ruptured intracranial aneurysms arising at the bifurcation were treated with LVIS™ stent-assisted coiling in our hospital between January 2017 and December 2021. The clinical data and angiographic results of the patients were analyzed.ResultsAmong these patients, all stents were successfully implanted. According to the immediate angiographic results, 29 aneurysms (70.7%) were completely occluded. Intraoperative thrombosis and hemorrhage occurred in two and one cases, respectively. No post-operative thrombosis or rebleeding events were observed. The clinical follow-up of all patients revealed that 38 (92.7%) cases had favorable outcomes (modified Rankin scale: 0–2). The angiographic results available for the 36 patients during the follow-up period revealed complete occlusion was achieved in 30 patients (83.3%) and residual neck in six patients.ConclusionThe LVIS™ stent-assistant coiling is a safe and feasible option for acutely ruptured bifurcation aneurysms. Further studies with a prospective design, a larger sample size, and long-term follow-up are needed to validate these findings.

Clinical Outcomes of Clipping and Coil Embolization for Ruptured Intracranial Aneurysms Categorized by Region and Hospital Size: A Nationwide Cohort Study in Korea

“…However, due to the lack of large-scale or prospective studies, it is still challenging to justify the use of stent-assisted coiling in the treatment of ruptured cerebral aneurysms. 16 17 18 19 …”

Endovascular Treatment of Wide-Neck Bifurcation Aneurysm: Recent Trends in Coil Embolization with Adjunctive Technique

“…15) In another report on SAC with LVIS for ruptured bifurcation aneurysms,theratesofcompleteocclusionduringthefollow-up period,intraproceduralthrombosis,andintraoperativehem-orrhagewere83.3%,4.9%,and2.4%,respectively. 16) InthemostrecentreportonSACtreatmentforWNBAs, theratesofcompleteocclusionduringfollow-upandprocedure-related permanent morbidity were 80.8%-90.9% and1.5%-8.6%,respectively. [17][18][19] Althoughthesestudies have shown favorable results, treatment of WNBAs in which both branches are involved in the neck can be very difficultusingasinglestent.Insuchcases,developmental techniques such as the waffle cone technique orY-stentassistedcoilingmaybeapplied.Neck-bridgingstentsfor coil embolization not only provide a mechanical scaffolding effect but also lead to the development of flow-diverterstents,focusingontheflow-divertinghemodynamiceffect.…”

“… 15) In another report on SAC with LVIS for ruptured bifurcation aneurysms, the rates of complete occlusion during the follow-up period, intraprocedural thrombosis, and intraoperative hemorrhage were 83.3%, 4.9%, and 2.4%, respectively. 16) …”

Navigating complexity: a comprehensive review of microcatheter shaping techniques in endovascular aneurysm embolization

“…In light of recent advancements in technology and material sciences, endovascular intervention techniques have emerged as significant therapeutic modalities for managing intracranial aneurysms ( 1 ). These techniques have garnered preference from both patients and clinicians owing to their minimally invasive nature and expedited recovery period ( 2 , 3 ). Nonetheless, the execution of endovascular embolization therapy, whether it employs simple coil embolization or is supplemented by stents or balloons, faces a principal technical challenge in accurately navigating the microcatheter into the aneurysm sac and ensuring its stability therein ( 4 ).…”