Y-stenting with braided stents for wide-neck intracranial bifurcation aneurysms. A single-center initial experience

Mihalea, Cristian; Caroff, Jildaz; Ikka, Léon; Benachour, Nidhal; Ros, Valerio Da; Abdelkhalek, Hazem; Iacobucci, Marta; Torre, Joaquin Jose Marenco de la; Pagiola, Igor; Yasuda, Thomas; Popa, Bogdan; Pleș, Horia; Pescariu, S.; Moret, Jacques; Spelle, Laurent

doi:10.1016/j.neurad.2018.12.005

Cited by 4 publications

(2 citation statements)

References 23 publications

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“…In addition, braided stents, like LVIS Jr, may have a number of advantages over their laser cut competition including perhaps increased metal coverage, improved neointimal growth, the ability to ''shelf'' the stents and more reliable opening. [6][7][8][9] Braided Y-stent constructs have been demonstrated to have impressive flowdiverting properties independent of intrasaccular treatment of aneurysms. [10][11][12] Compared to complex multistent constructs with open-celled stents, those aneurysms treated with braided stents may have better long-term radiographic outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…7,[15][16][17][18][19][20] At least six case series have specifically looked at Y-stent or other multistent constructs with braided stents. 6,14,[21][22][23][24] Three of these series specifically limited themselves to aneurysms treated with Y-stent LVIS Jr constructs. 21,22,24 However, one of these case series included only two cases, and the number of reported cases of aneurysms treated with LVIS Jr Y-stent constructs remains low.…”

Section: Introductionmentioning

confidence: 99%

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Cerebral aneurysms treated with low-profile visualized intraluminal support device (LVIS Jr) Y-stent constructs: Technical experience with a single microcatheter technique

Son¹,

Page

Niemann

2019

Interv Neuroradiol

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Background The LVIS Jr device holds a number of advantages but poses unique technical challenges compared to such, especially, complex multistent constructs. We report our experience with the technical feasibility and early to mid-term outcomes of Y-stent-assisted coiling with the LVIS Jr using a simple, single microcatheter technique. Methods Using a departmental database, we retrospectively reviewed a single surgeon’s experience with Y-stent-assisted coiling with LVIS Jr over a three-year period. Eighteen aneurysms in 17 patients were treated over this period. We assessed the technical success of the procedures, the initial and follow-up radiographic success with the modified Raymond-Roy occlusion score and follow-up clinical outcome with the modified Rankin scale. Results All stents were successfully deployed, and 17 of 18 aneurysms were successfully coiled at the initial treatment for a technical success rate of 94.4%. Of the 17 aneurysms with follow-up imaging, all were modified Raymond-Roy grade 1 or 2. One aneurysm required retreatment for coil compaction and a growing neck. There were two immediate postprocedure symptomatic strokes and one delayed stroke related to antiplatelet non-compliance. The two immediate symptomatic strokes recovered to neurological baseline with no residual deficits by the time of discharge. The long-term morbidity rate was 5.5%. The mortality rate was 0%. All patients had a modified Rankin Scale ≤ 2 at most recent follow-up. Conclusion Treatment with LVIS Jr Y-stent constructs via a single microcatheter technique is technically feasible with good radiographic and clinical outcomes.

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