Long-term outcomes of Low-profile Visualized Intraluminal Support device usage in stent-assisted coiling of intracranial aneurysm

Stent-assisted coil embolization technique have broadened indications for endovascular therapy of aneurysms. The Low-profile Visualized Intraluminal Support device (LVIS) is a self-expanding, nitinol single-braid and closed-cell device introduced fairly recently. We aim to evaluate long-term outcome of LVIS device in stent-assisted coiling of intracranial aneurysms. Between October 2012 and February 2013, a total of 55 patients with unruptured wide-necked intracranial aneurysms underwent coil embolization procedures involving LVIS devices. Clinical and anatomic parameters assessed included extent of aneurysmal occlusion, stent deployment status, and delayed complications. Anatomic outcomes were evaluated via DSA, MRA, and plain radiography (PR). Three patients were lost to follow-up after 6 months, but in 37 of 52 qualifying patients (mean follow-up, 27.1 months; range, 12-36 months) post-coiling recanalization was evaluable by DSA or MRA. Only one patient (2.7%) experienced minor recanalization, all others (97.3%) showing complete occlusion. Coil configurations were consistently stable by PR in 15 other patients (mean follow-up, 34.1 months; range, 30-39 months). No migration or altered expansion of stents was evident in 30 patients with available DSA and/or PR images. Three patients (5.8%) suffered delayed cerebral ischemia without neurologic sequelae, all as transient ischemic attacks and all related to withdrawal or change of anti-platelet medications. LVIS device usage in stent-assisted coil embolization of intracranial aneurysms provides excellent long-term results in terms of safety, efficacy and durability.