Endovascular treatment of middle cerebral artery aneurysm with a (LVIS) device: Comparison of LVIS stent and non‑LVIS stent

Chen, Feiyu; Fang, Xiaoyu

doi:10.3892/etm.2018.7139

Cited by 6 publications

(4 citation statements)

References 29 publications

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“…Our propensity score-matched cohort study showed that for wide-necked acutely RIAs, LVIS SAC yielded lower rates of perioperative overall procedure-related complications and intraprocedural aneurysm rupture than laser-cut SAC (5.6% vs 14.0%, P = 0.028; 0.7% vs 6.5%, P = 0.016). These results were similar to Chen’s study, which analyzed 92 cases of SAC for unruptured middle cerebral artery aneurysms and found that LVIS SAC significantly reduced the incidence of intraoperative aneurysm rupture compared with laser-cut SAC [ 38 ]. In addition, our present results indicated that the LVIS stent group had a higher complete occlusion rate and lower recurrence rate than the laser-cut stent group (92.7% vs 80.6%; 3.7% vs 9.7%).…”

Section: Discussionsupporting

confidence: 87%

Safety and efficacy of stent-assisted coiling for acutely ruptured wide-necked intracranial aneurysms: comparison of LVIS stents with laser-cut stents

et al. 2021

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Background To compare the safety and efficacy of LVIS stent-assisted coiling with those of laser-cut stent-assisted coiling for the treatment of acutely ruptured wide-necked intracranial aneurysms. Methods Patients with acutely ruptured wide-necked intracranial aneurysms treated with LVIS stent-assisted coiling (LVIS stent group) and laser-cut stent-assisted coiling (laser-cut stent group) were retrospectively reviewed from January 2014 to December 2017. Propensity score matching was used to adjust for potential differences in age, sex, aneurysm location, aneurysm size, neck width, Hunt-Hess grade, and modified Fisher grade. Perioperative procedure-related complications and clinical and angiographic follow-up outcomes were compared. Univariate and multivariate analyses were performed to determine the associations between procedure-related complications and potential risk factors. Results A total of 142 patients who underwent LVIS stent-assisted coiling and 93 patients who underwent laser-cut stent-assisted coiling were enrolled after 1:2 propensity score matching. The angiographic follow-up outcomes showed that the LVIS stent group had a slightly higher complete occlusion rate and lower recurrence rate than the laser-cut stent group (92.7% vs 80.6%; 3.7% vs 9.7%, P = 0.078). The clinical outcomes at discharge and follow-up between the two groups demonstrated no significant differences (P = 0.495 and P = 0.875, respectively). The rates of intraprocedural thrombosis, postprocedural thrombosis, postoperative early rebleeding, and procedure-related death were 0.7% (1/142), 1.4% (2/142), 2.8% (4/142), and 2.1% (3/142) in the LVIS stent group, respectively, and 4.3% (4/93), 2.2% (2/93), 1.1% (1/93), and 3.2% (3/93) in the laser-cut stent group, respectively (P = 0.082, 0.649, 0.651, and 0.683). Nevertheless, the rates of overall procedure-related complications and intraprocedural rupture in the LVIS stent group were significantly lower than those in the laser-cut stent group (5.6% vs 14.0%, P = 0.028; 0.7% vs 6.5%, P = 0.016). Multivariate analysis showed that laser-cut stent-assisted coiling was an independent predictor for overall procedure-related complications (OR = 2.727, P = 0.037); a history of diabetes (OR = 7.275, P = 0.027) and other cerebrovascular diseases (OR = 8.083, P = 0.022) were independent predictors for ischemic complications, whereas none of the factors were predictors for hemorrhagic complications. Conclusions Compared with laser-cut stent-assisted coiling, LVIS stent-assisted coiling for the treatment of acutely ruptured wide-necked intracranial aneurysms could reduce the rates of overall procedure-related complications and intraprocedural rupture.

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Section: Discussionsupporting

confidence: 87%

Safety and efficacy of stent-assisted coiling for acutely ruptured wide-necked intracranial aneurysms: comparison of LVIS stents with laser-cut stents

et al. 2021

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“…The “barrel technique” (pushing the stent across the aneurysm to make the stent partially protrude into the aneurysm) provides better protection for the wide aneurysm neck and the involved side-branches, and also enabled a better vessel attachment of the stent. A study comparing LVIS stent-assisted coiling (53 cases) and non-LVIS stent-assisted coiling (49 cases) for the treatment of unruptured MCA aneurysms also showed that coiling with LVIS stents increased treatment safety ( 16 ). Secondly, a modified antiplatelet regimen could help.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Treatment of Ruptured Middle Cerebral Artery Aneurysms With a Low-Profile Visualized Intraluminal Support Device

et al. 2021

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Objective: Stenting in ruptured middle cerebral artery (MCA) aneurysms was reported with a high perioperative complication rate. However, the treatment devices and physician's experience have continued to evolve. We performed this retrospective study to evaluate the safety and efficacy of LVIS stent-assisted coiling for ruptured MCA aneurysms.Methods: Patients with acutely ruptured MCA aneurysms treated between November 2014 and October 2019 were retrospectively reviewed. Clinical and angiographic data of those treated with LVIS stents were collected from a prospectively maintained database.Results: A total of 40 patients with 40 ruptured MCA aneurysms were enrolled, which comprised 26.3% (40/152) of all the ruptured MCA aneurysms at the same time. All stents were successfully deployed except for one (2.5%), which had a poor stent opening. Ischemic procedure-related complications were encountered in three patients (7.5%). One patient died of complications related to high-grade SAH on admission. Follow-up (mean 15.9 months) angiography was performed for 36 patients, which showed 33 (91.7%) aneurysms were completely occluded, 1 (2.8%) was improved, 1 (2.8%) was stable, and 1 (2.8%) was recanalized. Clinical follow-up (mean 29.6 months) was available for all survived patients, which showed 38 (95.0%) patients had favorable neurologic outcomes (mRS score 0–2), and 2 (5.0%) patients had poor neurologic outcomes.Conclusion: The use of LVIS stents is feasible, safe, and effective with glycoprotein IIb/IIIa inhibitor for the treatment of ruptured MCA aneurysms in the acute setting. Prospective, multicenter studies with larger sample sizes are still required to further evaluate the safety and long-term efficacy.

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“…MCA proximal and distal aneurysms are relatively rare, and most previous studies of proximal and distal aneurysms focus on the selection of treatment options for aneurysm rupture. Few studies exist on the relationship between MCA geometry and the formation of proximal and distal aneurysms [24][25][26][27]. To the best of our knowledge, the relation of both the α and β to the formation of proximal and distal MCA aneurysms has not yet been reported.…”

Section: Morphological Features Between Mca Proximal and Distal Aneurmentioning

confidence: 99%

Morphological parameters of middle cerebral arteries associated with aneurysm formation

Zhang

Wang

et al. 2020

Neuroradiology

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Purpose The objective of this work was to investigate the correlation between morphological parameters of the MCA and the formation of aneurysms. Methods MCA aneurysms were diagnosed in 122 cases using CT angiography (including 30 cases of M1 proximal aneurysms, 70 cases of M1 bifurcation aneurysms, and 22 cases of distal aneurysms). Images from these cases were retrospectively compared with images from 50 healthy controls. Morphological parameters including the angle of the MCA with the ICA (α) and the ACA (β) were evaluated in the three aneurysm groups and the control group; parent-daughter angles (γ 1 , γ 2), bifurcation angles (γ 3), bifurcation diameters, angle ratios, and branch diameter ratios were also compared between the bifurcation aneurysm group and the control group. The blood vessel parameters between the aneurysm groups and controls were analyzed statistically. Results There was no statistically significant difference in α between the three groups of aneurysms and the control group (P = 0.381). In comparing β between the three groups of aneurysms and the control group, statistically significant differences were only observed between the MCA distal aneurysm group and the control group (P = 0.010). Compared with the control group, MCA bifurcation aneurysms were associated with larger γ 3 and smaller γ 1 and γ 2 (P < 0.001). This resulted in significantly larger angle ratios in the MCA bifurcation aneurysm group (P < 0.001). For the diameter measurements, the bifurcation diameter of the MCA bifurcation aneurysms was significantly smaller (P = 0.001). Conclusion The formation of MCA aneurysms is related to morphological parameters.

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Endovascular treatment of middle cerebral artery aneurysm with a (LVIS) device: Comparison of LVIS stent and non‑LVIS stent

Cited by 6 publications

References 29 publications

Safety and efficacy of stent-assisted coiling for acutely ruptured wide-necked intracranial aneurysms: comparison of LVIS stents with laser-cut stents

Safety and efficacy of stent-assisted coiling for acutely ruptured wide-necked intracranial aneurysms: comparison of LVIS stents with laser-cut stents

Endovascular Treatment of Ruptured Middle Cerebral Artery Aneurysms With a Low-Profile Visualized Intraluminal Support Device

Morphological parameters of middle cerebral arteries associated with aneurysm formation

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