Endovascular treatment of patients with intracranial aneurysms: feasibility and successful employment of a new low profile visible intraluminal support (LVIS) EVO stent

Abstract

Background and purpose Low-profile self-expandable stents have increased the number of intracranial aneurysms treated by endovascular means. The new low-profile visible intraluminal support device LVIS EVO (Microvention), the successor of LVIS Jr, is a self-expandable and retrievable microstent system, designed for implantation into intracranial arteries with a diameter up to 2.0 mm. In this retrospective study we aimed to elucidate the technical feasibility and clinical safety of the novel LVIS EVO stent for stent-assisted coil embolisation of intracranial aneurysms. Materials and methods A single centre technical report of the first six consecutive cases of stent-assisted coil embolisation with the novel LVIS EVO stent for the treatment of unruptured or recanalised intracranial aneurysms. Records were made of basic demographics, aneurysmal characteristics, device properties and related technical details, adverse events, clinical outcomes and occlusion rates on available radiological follow-up. Results Six LVIS EVO devices were successfully implanted in all subjects to treat a total number of six intracranial aneurysms. No device-related intraprocedural complications were seen. At early clinical follow-up six out of six (100%) patients had a modified Ranking score of 0–1. Early angiographic and cross-sectional radiological follow-up, available in five out of six (83.3%) of the patients confirmed unchanged aneurysmal occlusion rates. A minor, transitory neurological deficit was recorded in one of the six (16.6%) patients. Mortality was 0%. Conclusions Preliminary experience in this subset of our patients confirms a notably improved technical behaviour of the novel LVIS EVO stent system when compared to its ancestor LVIS Jr. The enhanced visibility of the stent and the refined delivery/retrieval capabilities of the stent further increase the safety margins of the devices profile, especially in cases of tortuous anatomy.

Endovascular Treatment of Intracranial Aneurysms Using the Novel Low Profile Visualized Intraluminal Support EVO Stent: Multicenter Early Feasibility Experience

“…In comparison to our study with immediate complete occlusion (RROC 1) in 64% (7/11) of SAC cases, 2 recent single-center observational studies of LVIS EVO SAC (Sirakov et al 11 [n=6]; Poncyljusz et al 12 [n=35]) both reported immediate RROC 1 in 100% of cases. The poorer angiographic outcomes in our study may be explained by a number of differences in baseline aneurysm characteristics.…”

Endovascular Therapy for Basilar Arterial Trunk Aneurysms

“…Among saccular aneurysms, single coiling can be used for narrow-necked aneurysms, while a low-metal-coverage stent is needed for wide-necked aneurysms to reduce the impact of the stent on BA perforations ( 18 ). When aneurysms involve spherical or fusiform dissections of the BA, they can only be coiled at first, followed by BA channel reconstruction with a stent ( 19 ). Nevertheless, we realize that even very successful EVT operations may develop serious complications or consequences postoperatively.…”

First multicenter experience using the Silk Vista flow diverter in 60 consecutive intracranial aneurysms: technical aspects

“…Increasing the number of devices and the procedural time have been related to intra/periprocedural complications. 11 12 Although low profile stents and low-profile FDs have shown great benefits for the treatment of aneurysms located distal to the circle of Willis, [12][13][14] the use of a lower profile FD for aneurysms arising more proximally has not been assessed.…”