Clinical effect of LVIS stent-assisted coiling of unruptured intracranial aneurysms

Abstract

Objective To investigate the safety and efficacy of the LVIS stent-assisted coiling of unruptured intracranial aneurysms. Methods We retrospectively analyzed 62 patients who underwent LVIS stent-assisted coiling treatment for unruptured intracranial aneurysms at Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, between November 2015 and November 2016. Demographic and clinical factors, including initial clinical presentation, risk factors, location and size of aneurysm, Raymond Classification following initial treatment as well as perioperative complications, were documented. Regular follow-up of the cases was conducted post operation to assess the surgical outcomes. Results The 62 patients in this study had a total of 78 unruptured intracranial aneurysms. Among them, 62 aneurysms were treated with single LVIS stent, 6 aneurysms with double LVIS stents, 3 aneurysms with 3 LVIS stents, and 1 aneurysm was treated with Neuroform stent and LVIS stent Y -shaped assisted coiling. Raymond Classification following initial treatment indicated that 30 cases (50%) were in class 1, 23 cases (29.5%) in class 2 and 16 cases (20.5%) in class 3. The incidence rate of perioperative complications was 4.8% (3/62). Hemorrhagic event of aneurysmal rupture occurred in 1 patient during coiling who received symptomatic treatment and recovered at discharge. Perforator puncture occurred in 1 case during coiling, and the patient died from secondary in-stent thrombosis formed post procedure. One patient died from nonaneurysmal postprocedural rebleeding. Sixty cases were followed up for 4-13 months with a mean of 7.2±3.1 months. Imaging was followed up in 32 cases with 44 aneurysms. Based on Raymond scale, 31 out of 44 (70.5%) aneurysms belonged to class 1 (complete occlusion). Mild recurrence was reported in 1 (2.3%) case which received continuous clinical observation. Twenty-eight patients with 32 aneurysms were followed up by telephone and recovered well. Conclusion Endovascular treatment of unruptured intracranial aneurysms with LVIS stent-assisted coiling is suggested to be safe and effective, and the mid-term follow-up results seems satisfactory. Key words: Intracranial aneurysms; Endovascular procedures; Embolization, therapeutic; Treatment outcome; LVIS stent