Low-Profile Visualized Intraluminal Support Device for Y-Stent-Assisted Coiling of Wide-Neck Intracranial Aneurysms: A Single-Center Experience

Abstract

BackgroundThe Low-Profile Visualized Intraluminal Support (LVIS) device has been frequently used as intracranial stent for treating intracranial aneurysms. However, the feasibility and efficacy of LVIS devices in Y-stent-assisted coiling (Y-SAC) have remained contentious. This study aimed to evaluate long-term angiographic and clinical outcomes of Y-SAC using LVIS devices. MethodsWe retrospectively reviewed the clinical presentation and angiography data of patients treated with Y-SAC using LVIS stents. The vascular angle geometry between the parent and the two branch vessels, before and after stent deployment and after coiling were analyzed. Based on Raymond-Roy Occlusion Classification (RROC), aneurysm occlusion status was classified. Clinical outcomes were assessed using the modified Rankin Scale (MRS). ResultsForty patients with 40 aneurysms were included in this study. Immediate postprocedural angiograms revealed complete/near-complete occlusion (RROC 1 and 2) in 31 aneurysms (77.5%). The long-term follow-up angiographic studies were available in 32 patients revealing RROC class 1 and 2 in 93.8% of patients. Y-SAC with LVIS devices significantly decreased the angle between the bifurcation branches from 171.90 ° ± 48.0° (SD) to 130.21° ± 46.3° (SD) (p<0.0001). Periprocedural complications occurred in five patients (12.5%) including four in-stent thrombosis (10.5%). Thirty-six patients (90.0%) had favorable clinical outcomes at the final follow-up. Univariate analysis depicted that WFNS of 3-5, thick of subarachnoid hemorrhage on head CT scan, intraprocedural complications, and in-stent thrombosis were predictors of poor outcome. ConclusionY-SAC using LVIS device for intracranial bifurcation aneurysms is a feasible and relatively safe procedure with favorable long-term angiographic and clinical outcomes.