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Double Stent-Assisted (Y and X) Coil Embolization of Unruptured Intracranial Saccular Aneurysms using the Low-Profile Visualized Intraluminal Support Device-Single Center Experience.
PURPOSE: To study the feasibility, safety, and durability of the dual stent-assisted coil embolization (DSCE) technique using low-profile visualized intraluminal support (LVIS) device.
METHODS: Retrospective review of our aneurysm database to identify all the patients treated with LVIS stent-assisted embolization between July 2015 and June 2017 was performed. 15% of the patients with Y- or X-configuration DSCE constituted the study population. Patient demographics, clinical presentation, aneurysm characteristics (location, dome, and dome/neck ratio), periprocedural complications, immediate and follow-up angiographic and clinical outcomes were reported.
RESULTS: Twelve patients (15%) with unruptured, wide-necked branching aneurysms underwent DSCE using LVIS Junior stents. M:F-1:11. Mean age of 60 ± 11 years. 75% ( n = 9) aneurysms are located in anterior circulation. Recurrent aneurysms were treated in 17% ( n = 2). Mean aneurysm diameter was 8 ± 3.4 mm and the dome/neck ratio was 1.6 ± 0.4. Periprocedural complications were noted in 25% ( n = 3; transient in-stent thrombus = 2 and iatrogenic rupture = 1) with no clinical sequelae. Immediate aneurysm obliteration following DSCE was noted in all (100%) patients. Mean time-of-flight (TOF) magnetic resonance angiography (MRA) follow-up was 10 ± 6 months (Range: 5-19 months). Mean clinical follow-up was 12 ± 6 months (Range: 5-21 months). Stable neck recurrence was demonstrated in 25% ( n = 3). The average modified Rankin Score (mRS) at prestent, 24-hour poststent, and last clinical follow-up were: 0.5 (Range: 0-1), 0.75 (Range: 0-1), and 0.5 (Range: 0-1), respectively.
CONCLUSION: We report the first dedicated DSCE experience with LVIS Junior stents in the literature. DSCE with LVIS Junior stents for intracranial complex wide-neck branching aneurysms is feasible, safe, and effective with good clinical outcomes.
METHODS: Retrospective review of our aneurysm database to identify all the patients treated with LVIS stent-assisted embolization between July 2015 and June 2017 was performed. 15% of the patients with Y- or X-configuration DSCE constituted the study population. Patient demographics, clinical presentation, aneurysm characteristics (location, dome, and dome/neck ratio), periprocedural complications, immediate and follow-up angiographic and clinical outcomes were reported.
RESULTS: Twelve patients (15%) with unruptured, wide-necked branching aneurysms underwent DSCE using LVIS Junior stents. M:F-1:11. Mean age of 60 ± 11 years. 75% ( n = 9) aneurysms are located in anterior circulation. Recurrent aneurysms were treated in 17% ( n = 2). Mean aneurysm diameter was 8 ± 3.4 mm and the dome/neck ratio was 1.6 ± 0.4. Periprocedural complications were noted in 25% ( n = 3; transient in-stent thrombus = 2 and iatrogenic rupture = 1) with no clinical sequelae. Immediate aneurysm obliteration following DSCE was noted in all (100%) patients. Mean time-of-flight (TOF) magnetic resonance angiography (MRA) follow-up was 10 ± 6 months (Range: 5-19 months). Mean clinical follow-up was 12 ± 6 months (Range: 5-21 months). Stable neck recurrence was demonstrated in 25% ( n = 3). The average modified Rankin Score (mRS) at prestent, 24-hour poststent, and last clinical follow-up were: 0.5 (Range: 0-1), 0.75 (Range: 0-1), and 0.5 (Range: 0-1), respectively.
CONCLUSION: We report the first dedicated DSCE experience with LVIS Junior stents in the literature. DSCE with LVIS Junior stents for intracranial complex wide-neck branching aneurysms is feasible, safe, and effective with good clinical outcomes.
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