Skip to main content

Advertisement

Log in

The LVIS Jr. microstent to assist coil embolization of wide-neck intracranial aneurysms: clinical study to assess safety and efficacy

  • Interventional Neuroradiology
  • Published:
Neuroradiology Aims and scope Submit manuscript

Abstract

Introduction

This study was aimed to assess clinical safety and efficacy of the LVIS Jr. microstent in stent-assisted coil embolization of wide-neck intracranial aneurysms.

Methods

IRB approved single-center interventional clinical study in 22 patients (10 females, 12 males, mean age 55, age range 33–74 years) for the endovascular treatment of wide-neck aneurysms. After obtaining informed consent, patients were included according to the following criteria: aneurysm fundus-to-neck ratio < 2 or neck diameter > 4 mm, and a parent vessel diameter of ≤3.5 mm. Primary end point for clinical safety was absence of death, absence of major or minor stroke, and absence of transient ischemic attack. Primary end point for treatment efficacy was complete angiographic occlusion according to the Raymond–Roy Occlusion Classification (RROC) immediately after the procedure and at follow-up after 3 and 6 months on magnetic resonance imaging (MRI).

Results

In 20/22 (91 %) of patients, the primary end point of safety was reached; in the two remaining patients, transient ischemic attack, but no permanent deficit was observed; in 16/22 (73 %), efficient occlusion (RROC1) was reached, and in 6/22 (27 %), a residual neck remained (RROC2). Single [seven with antegrade, two in crossover configuration, and four with “first-balloon-then-stent” (FBTS) technique] or double-stent (eight patients with Y configuration and one patient with X configuration) deployment was technically successful in all cases.

Conclusion

Deployment of the LVIS Jr. microstent in various single- or double-stent configurations is safe and effective to assist the treatment of intracranial wide-neck aneurysms.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Alshekhlee A, Mehta S, Edgell RC et al (2010) Hospital mortality and complications of electively clipped or coiled unruptured intracranial aneurysm. Stroke 41:1471–1476

    Article  PubMed  Google Scholar 

  2. Brinjikji W, Rabinstein AA, Nasr DM et al (2011) Better outcomes with treatment by coiling relative to clipping of unruptured intracranial aneurysms in the United States, 2001–2008. AJNR Am J Neuroradiol 32:1071–1075

    Article  CAS  PubMed  Google Scholar 

  3. Molyneux A, Kerr R, Stratton I et al (2002) International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial. Lancet 360:1267–1274

    Article  PubMed  Google Scholar 

  4. White PM, Lewis SC, Gholkar A et al (2011) Hydrogel-coated coils versus bare platinum coils for the endovascular treatment of intracranial aneurysms (HELPS): a randomised controlled trial. Lancet 377:1655–1662

    Article  CAS  PubMed  Google Scholar 

  5. Moret J, Cognard C, Weill A et al (1997) The “remodelling technique” in the treatment of wide neck intracranial aneurysms. Angiographic results and clinical follow-up in 56 cases. Interv Neuroradiol 3:21–35

    CAS  PubMed  Google Scholar 

  6. Biondi A, Janardhan V, Katz JM et al (2007) Neuroform stent-assisted coil embolization of wide-neck intracranial aneurysms: strategies in stent deployment and midterm follow-up. Neurosurgery 61:460–468

    Article  PubMed  Google Scholar 

  7. Lubicz B, Francois O, Levivier M et al (2008) Preliminary experience with the enterprise stent for endovascular treatment of complex intracranial aneurysms: potential advantages and limiting characteristics. Neurosurgery 62:1063–1069

    Article  PubMed  Google Scholar 

  8. Lubicz B, Leclerc X, Levivier M et al (2006) Retractable self-expandable stent for endovascular treatment of wide-necked intracranial aneurysms: preliminary experience. Neurosurgery 58:451–457

    Article  PubMed  Google Scholar 

  9. Bendok BR, Parkinson RJ, Hage ZA et al (2007) The effect of vascular reconstruction device-assisted coiling on packing density, effective neck coverage, and angiographic outcome: an in vitro study. Neurosurgery 61:835–841

    Article  PubMed  Google Scholar 

  10. Izar B, Rai A, Raghuram K et al (2011) Comparison of devices used for stent-assisted coiling of intracranial aneurysms. PLoS One. doi:10.1371/journal.pone.0024875

    Google Scholar 

  11. Kovács A, Möhlenbruch M, Hadizadeh DR et al (2011) Noninvasive imaging after stent-assisted coiling of intracranial aneurysms: comparison of 3-T magnetic resonance imaging and 64-row multidetector computed tomography—a pilot study. J Comput Assist Tomogr 35:573–582

    Article  PubMed  Google Scholar 

  12. Majoie CB, Sprengers ME, van Rooij WJ et al (2010) MR angiography at 3T versus digital subtraction angiography in the follow-up of intracranial aneurysms treated with detachable coils. AJNR Am J Neuroradiol 26:1349–1356

    Google Scholar 

  13. Weber W, Bendszus M, Kis B et al (2007) A new self-expanding nitinol stent (enterprise) for the treatment of wide-necked intracranial aneurysms: initial clinical and angiographic results in 31 aneurysms. Neuroradiology 49:555–561

    Article  PubMed  Google Scholar 

  14. Gentric JC, Biondi A, Piotin M et al (2013) Safety and efficacy of neuroform for treatment of intracranial aneurysms: a prospective, consecutive, French multicentric study. AJNR Am J Neuroradiol 34:1203–1208

    Article  CAS  PubMed  Google Scholar 

  15. Gory B, Klisch J, Bonafe A et al (2013) Solitaire AB stent-assisted coiling of wide-necked intracranial aneurysms: short-term results from a prospective, consecutive, European multicentric study. Neuroradiology 55:1373–1378

    Article  PubMed  Google Scholar 

  16. Gao B, Malek AM (2010) Possible mechanisms for delayed migration of the closed cell-designed enterprise stent when used in the adjunctive treatment of a basilar artery aneurysm. AJNR Am J Neuroradiol. doi:10.3174/ajnr.A2258

    Google Scholar 

  17. Cekirge SH, Yavuz K, Geyik S et al (2007) HyperForm balloon-assisted endovascular neck bypass technique to perform balloon or stent-assisted treatment of cerebral aneurysms. AJNR Am J Neuroradiol 28:1388–1390

    Article  CAS  PubMed  Google Scholar 

  18. Spiotta AM, Miranpuri A, Chaudry MI et al (2013) Combined balloon stent technique with the Scepter C balloon and low-profile visualized intraluminal stent for the treatment of intracranial aneurysms. J Neuro Intervent Surg. doi:10.1136/neurintsurg-2012-010553

    Google Scholar 

Download references

Conflict of interest

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. Möhlenbruch.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Möhlenbruch, M., Herweh, C., Behrens, L. et al. The LVIS Jr. microstent to assist coil embolization of wide-neck intracranial aneurysms: clinical study to assess safety and efficacy. Neuroradiology 56, 389–395 (2014). https://doi.org/10.1007/s00234-014-1345-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00234-014-1345-z

Keywords

Navigation