The p64 Flow Diverter—Mid-term and Long-term Results from a Single Center

Sirakov, Stanimir; Sirakov, Alexander; Bhogal, Pervinder; Penkov, Marin; Minkin, Krasimir; Ninov, Kristian; Hristov, Hristo; Karakostov, Vasil; Raychev, Radoslav

doi:10.1007/s00062-019-00823-y

Cited by 24 publications

(24 citation statements)

References 33 publications

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“…Our observations are based on the fact that adjunctive coil embolisation via either temporary or permanent stenting is used in up to 60% of 260 cases annually by our neurointerventional team -SS (senior) and AS (junior). [11][12][13] The early observations indicate that the device's technical behaviour shows subjective non-inferiority in comparison with the already reported preliminary outcomes of its ancestors -LVIS Jr or any other similar low-profile endoluminal device. [14][15][16][17][18][19] In our limited study sample, the implant demonstrated solid technical success with a good safety profile.…”

Section: Discussionmentioning

confidence: 94%

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

et al. 2020

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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.

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Section: Discussionmentioning

confidence: 94%

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

et al. 2020

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“…Flow diverter stents (FDSs) have significantly improved endovascular treatment of challenging intracranial aneurysms in recent years (1,2). A number of earlier studies reported good safety and efficacy in reviewing short-term follow-ups (3)(4)(5), which has recently been substantiated by reports of excellent long-term outcomes after implantation of the Pipeline embolization device (PED, Medtronic, Dublin, Ireland) (6) and the p64 (phenox, Bochum, Germany) (7).…”

Section: Introductionmentioning

confidence: 99%

Single-Center Experience With the Bare p48MW Low-Profile Flow Diverter and Its Hydrophilically Covered Version for Treatment of Bifurcation Aneurysms in Distal Segments of the Anterior and Posterior Circulation

et al. 2020

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Conclusions: Implantation of the p48MW/p48MW HPC is safe and effective for treatment of distally located cerebral aneurysms. Considering the reported rates of Schob et al. p48MW for Distal Bifurcation Aneurysms ischemic complications associated with flow diversion of complex bifurcation aneurysms, the p48MW/p48MW HPC potentially provides increased safety for complex bifurcation aneurysms in the anterior and posterior circulation.

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“…Finally, 36 articles reporting on 60 patients were included in the final analysis (Table 1). 8 , 11–45 The flowchart of searching strategy is illustrated in Figure 1. The patients were aged from 29 to 86 (55.31 ± 13.98) ( n = 42) years, with a male to female ratio of 1:3 (11:33).…”

Section: Resultsmentioning

confidence: 99%

“…11 , 22 , 25 , 30 , 36 Of note, there was one patient who survived and experienced complete thrombosis of the aneurysm with just conservative management. 45…”

Section: Discussionmentioning

confidence: 99%

Delayed rupture of intracranial aneurysms after placement of intra-luminal flow diverter

Hou

et al. 2020

Neuroradiol J

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Background Though flow diverter is a safe and efficient modality, some patients can experience delayed aneurysmal rupture. The mechanism of delayed rupture is still obscure to us. Methods We performed a systematic search in the PubMed database for patients with delayed rupture of intracranial aneurysms after flow diverter placement. Results A total of 36 articles reporting on 60 patients were included in the final analysis. Of the 49 patients with description of presenting symptoms, six (12.2%) patients were incidentally diagnosed, 39 (87.8%) patients were admitted for aneurysmal rupture or mass effect. Multiple flow diverters were used in 38.3% (18/47) of the patients. Coil assistance was applied in 13.0% (7/54) of the patients. Delayed aneurysmal rupture led to intracranial hemorrhage or carotid–cavernous sinus fistula (CCF) in 76.8% (43/56) and 23.2% (13/56) of the patients, respectively. Of the 55 patients with description of outcome, 14 (25.5%) patients achieved good recovery, one (1.8%) patient was severely disabled, 40 (72.7%) patients died. All of the patients in the CCF group survived and experienced good recovery. Conclusion Increased intra-aneurysmal pressure, destabilization of the aneurysm wall by intra-aneurysmal thrombus, persistent residual intra-aneurysmal flow, characteristics of the specific aneurysm, and mechanical injury by the flow diverter might conjointly contribute to the final delayed rupture. There has been no established preventive measure to decrease the incidence of delayed rupture yet. The treatment and outcome depend on the presentation of delayed rupture. Patients presenting with aneurysm-related intracranial hemorrhage have a dismal outcome. Those presenting with CCFs usually have a satisfactory recovery.

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The p64 Flow Diverter—Mid-term and Long-term Results from a Single Center

Cited by 24 publications

References 33 publications

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

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

Single-Center Experience With the Bare p48MW Low-Profile Flow Diverter and Its Hydrophilically Covered Version for Treatment of Bifurcation Aneurysms in Distal Segments of the Anterior and Posterior Circulation

Delayed rupture of intracranial aneurysms after placement of intra-luminal flow diverter

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