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

Abstract

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. 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. 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. Treatment with LVIS Jr Y-stent constructs via a single microcatheter technique is technically feasible with good radiographic and clinical outcomes.