Y-configuration stenting for coiling of wide-neck bifurcation aneurysms using Low-profile Visualized Intraluminal Support Junior

Park, Keun Young; Kim, Byung Moon; Kim, Dong Joon; Chung, Joonho; Lee, Jae Whan

doi:10.1136/neurintsurg-2018-014128

Cited by 18 publications

(14 citation statements)

References 27 publications

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“…Despite the fact that our cohort consisted only of MCA aneurysms, which are considered technically challenging to treat by the endovascular approach, we achieved high immediate and long-term total occlusion rates, which are similar to, if not better than, those of other published LVIS Jr. series [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. Follow-up imaging showed complete or near-complete aneurysm occlusion in 92% of the cases.…”

Section: Discussionsupporting

confidence: 61%

“…High technical success rate (95%) was observed in our study, which is similar to previous papers. The reported rate of occurrence of in-stent thrombosis is variable in the literature [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. In another large series of aneurysms treated with the assistance of the LVIS Jr. by Shankar et al, it was observed in 14% of the cases.…”

Section: Discussionmentioning

confidence: 99%

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Stent-Assisted Coiling of Unruptured MCA Aneurysms Using the LVIS Jr. Device: A Multicenter Registry

Poncyljusz

Zwarzany

Limanówka

et al. 2020

JCM

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Purpose: The low-profile visualized intraluminal support junior (LVIS Jr.) is a new generation low-profile braided stent. Our aim was to evaluate the safety and efficacy of the LVIS Jr. in the stent-assisted coiling of unruptured middle cerebral artery (MCA) aneurysms. This was a multicenter retrospective study. Patient demographics, aneurysm characteristics, procedural details, complications, and the results of clinical and imaging follow-up were analyzed. Four centers participated in the study. A total of 162 consecutive patients with 162 unruptured MCA aneurysms were included for the analysis. The mean aneurysm size was 7.6 mm (range 2 to 37 mm) and 97.5% were wide-necked. Immediate postprocedural angiograms showed Raymond-Roy class 1 in 118 (72.8%), class 2 in 23 (14.2%), and class 3 in 21 patients (13%). Periprocedural complications occurred in 14 patients (8.6%). There were no procedure-related deaths. Follow-up imaging at 12–18 months post-procedure showed Raymond–Roy class 1 in 132 (81.5%), class 2 in 17 (10.5%), and class 3 in 13 patients (8%). There were 3 cases of in-stent stenosis (1.9%). All 162 patients had good clinical outcome (mRS score 0–2) at 90 days post-procedure. Stent-assisted coiling of unruptured MCA aneurysms with the LVIS Jr. stent is safe and effective, with high immediate and long-term total occlusion rates.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Stent-Assisted Coiling of Unruptured MCA Aneurysms Using the LVIS Jr. Device: A Multicenter Registry

Poncyljusz

Zwarzany

Limanówka

et al. 2020

JCM

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“…26,27 But as with the previous work of Park et al, Sanmaniego et al and Conrad et al, we enjoyed a high technical success rate with a single instance of asymptomatic in stent stenosis and no cases of stent migration. 21,22,24 We have found that the ability to compress the braided stent during deployment can greatly aid in its outward expansion and in the vast majority of cases relieves any poor opening that may be seen during deployment. In addition, the ability to recapture the LVIS Jr at up to 80% deployment gives a level of control and comfort, in case of poorly witnessed opening.…”

Section: Discussionmentioning

confidence: 99%

“…7,[15][16][17][18][19][20] At least six case series have specifically looked at Y-stent or other multistent constructs with braided stents. 6,14,[21][22][23][24] Three of these series specifically limited themselves to aneurysms treated with Y-stent LVIS Jr constructs. 21,22,24 However, one of these case series included only two cases, and the number of reported cases of aneurysms treated with LVIS Jr Y-stent constructs remains low.…”

Section: Introductionmentioning

confidence: 99%

“…6,14,[21][22][23][24] Three of these series specifically limited themselves to aneurysms treated with Y-stent LVIS Jr constructs. 21,22,24 However, one of these case series included only two cases, and the number of reported cases of aneurysms treated with LVIS Jr Y-stent constructs remains low. More importantly, previous case series reported results using a dual microcatheter setup, wherein the coiling microcatheter is ''jailed'' within the aneurysm prior to stent deployment.…”

Section: Introductionmentioning

confidence: 99%

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Cerebral aneurysms treated with low-profile visualized intraluminal support device (LVIS Jr) Y-stent constructs: Technical experience with a single microcatheter technique

Son¹,

Page

Niemann

2019

Interv Neuroradiol

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Background The LVIS Jr device holds a number of advantages but poses unique technical challenges compared to such, especially, complex multistent constructs. We report our experience with the technical feasibility and early to mid-term outcomes of Y-stent-assisted coiling with the LVIS Jr using a simple, single microcatheter technique. Methods Using a departmental database, we retrospectively reviewed a single surgeon’s experience with Y-stent-assisted coiling with LVIS Jr over a three-year period. Eighteen aneurysms in 17 patients were treated over this period. We assessed the technical success of the procedures, the initial and follow-up radiographic success with the modified Raymond-Roy occlusion score and follow-up clinical outcome with the modified Rankin scale. Results All stents were successfully deployed, and 17 of 18 aneurysms were successfully coiled at the initial treatment for a technical success rate of 94.4%. Of the 17 aneurysms with follow-up imaging, all were modified Raymond-Roy grade 1 or 2. One aneurysm required retreatment for coil compaction and a growing neck. There were two immediate postprocedure symptomatic strokes and one delayed stroke related to antiplatelet non-compliance. The two immediate symptomatic strokes recovered to neurological baseline with no residual deficits by the time of discharge. The long-term morbidity rate was 5.5%. The mortality rate was 0%. All patients had a modified Rankin Scale ≤ 2 at most recent follow-up. Conclusion Treatment with LVIS Jr Y-stent constructs via a single microcatheter technique is technically feasible with good radiographic and clinical outcomes.

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Low-Profile Laser-Cut Stents for Endovascular Treatment of Intracranial Aneurysms

et al. 2020

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Y-configuration stenting for coiling of wide-neck bifurcation aneurysms using Low-profile Visualized Intraluminal Support Junior

Abstract: LVIS Jr Y-stenting and coiling for wide-neck bifurcation aneurysms seems to be feasible with acceptable safety and to provide durable aneurysm occlusion for wide-neck bifurcation aneurysms.

Cited by 18 publications

References 27 publications

Stent-Assisted Coiling of Unruptured MCA Aneurysms Using the LVIS Jr. Device: A Multicenter Registry

Stent-Assisted Coiling of Unruptured MCA Aneurysms Using the LVIS Jr. Device: A Multicenter Registry

Cerebral aneurysms treated with low-profile visualized intraluminal support device (LVIS Jr) Y-stent constructs: Technical experience with a single microcatheter technique

Low-Profile Laser-Cut Stents for Endovascular Treatment of Intracranial Aneurysms

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