Journal article
LVIS Jr Device for Y-Stent-Assisted Coil Embolization of Wide-Neck Intracranial Aneurysms: A Multicenter Experience
Interventional neurology, Vol.7(5), pp.271-283
04/2018
DOI: 10.1159/000487545
PMCID: PMC5939862
PMID: 29765397
Abstract
Background and purpose: Complex wide-neck intracranial aneurysms are challenging to treat. We report a multicenter experience using the LVIS Jr stent for "Y-stent"-assisted coiling embolization of wide-neck bifurcation aneurysms.
Methods: Seven centers provided retrospective data on patients who underwent Y-stenting. Technical complications, immediate posttreatment angiographic results, clinical outcomes, and imaging follow-up were assessed.
Results: Thirty patients/aneurysms were treated: 15 basilar tip, 8 middle cerebral artery, 4 anterior communicating artery, 1 pericallosal, and 2 posterior inferior cerebellar artery aneurysms. The mean aneurysm size was 11 mm and the mean dome-to-neck ratio was 1.3 mm. Twenty-four aneurysms were unruptured and treated electively, and 6 were acutely ruptured. Fifty-eight LVIS Jr stents were successfully deployed without any technical issue. One pro-cedural and transient in-stent thrombosis resolved with the intravenous infusion of a glycoprotein IIb/IIIa inhibitor. Five periprocedural complications (within 30 days) occurred: 2 periprocedural neurological complications (1 small temporal stroke that presented with transient aphasia and 1 posterior cerebral artery infarct) and 3 nonneurological periprocedural complications (2 retroperitoneal hematomas, and 1 patient developed a disseminated intravascular coagulopathy). One permanent complication (3.3%) directly related to Y-stenting was reported in the patient who suffered the posterior cerebral artery infarct. Immediate complete obliteration (Raymond-Roy Occlusion Classification [RROC] I-II) was achieved in 26 cases (89.6%). Twenty-four patients had clinical and imaging follow-up (mean 5.2 months). Complete angiographic occlusion (RROC I-II) was observed in 23 patients (96%). A good functional outcome with a modified Rankin Scale score ≤2 was achieved in 26 cases.
Conclusions: In this multicenter case series, Y-stent-assisted coiling of wide-neck aneurysms with the LVIS Jr device was feasible and relatively safe. Follow-up imaging demonstrated very low recanalization rates.
Details
- Title: Subtitle
- LVIS Jr Device for Y-Stent-Assisted Coil Embolization of Wide-Neck Intracranial Aneurysms: A Multicenter Experience
- Creators
- Edgar A Samaniego - Department of Neurology, Neurosurgery and Radiology, University of Iowa, Iowa, Iowa, USAAldo A Mendez - Department of Neurology, Neurosurgery and Radiology, University of Iowa, Iowa, Iowa, USAThanh N Nguyen - Department of Neurology, Neurosurgery and Radiology, Boston Medical Center, Boston, Massachusetts, USAVladimir Kalousek - Department of Radiology, Clinical Hospital Center “Sestre Milosrdnice,”, Zagreb, CroatiaWaldo R Guerrero - Department of Neurology, Neurosurgery and Radiology, University of Iowa, Iowa, Iowa, USASudeepta Dandapat - Department of Neurology, Neurosurgery and Radiology, University of Iowa, Iowa, Iowa, USAGuilherme Dabus - Miami Cardiac and Vascular Institute and Baptist Neuroscience Center, Miami, Florida, USAItalo Linfante - Miami Cardiac and Vascular Institute and Baptist Neuroscience Center, Miami, Florida, USAAmeer E Hassan - Valley Baptist Medical Center, Harlingen, Texas, USAAlexander Drofa - Department of Neurosurgery, Sanford Brain & Spine Center, Fargo, North Dakota, USAEvgueni Kouznetsov - Department of Neurosurgery, Sanford Brain & Spine Center, Fargo, North Dakota, USADavid Leedahl - Pharmacy Services, Sanford Medical Center, Fargo, North Dakota, USADavid Hasan - Department of Neurosurgery, University of Iowa, Iowa, Iowa, USAAlberto Maud - Department of Neurology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, Texas, USASantiago Ortega-Gutierrez - Department of Neurology, Neurosurgery and Radiology, University of Iowa, Iowa, Iowa, USA
- Resource Type
- Journal article
- Publication Details
- Interventional neurology, Vol.7(5), pp.271-283
- Publisher
- S. Karger AG
- DOI
- 10.1159/000487545
- PMID
- 29765397
- PMCID
- PMC5939862
- ISSN
- 1664-9737
- eISSN
- 1664-5545
- Language
- English
- Date published
- 04/2018
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
- Record Identifier
- 9984040291702771
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