Abstract
Cerebral or intracranial aneurysm is a leading cause of subarachnoid hemorrhage. It was initially treated with open surgical clipping but as rapid development of technology a less invasive endovascular coiling technique of aneurysm revolutionized the treatment. Due to tortuous anatomy of parent artery and complicated morphology and location of aneurysm there is ongoing challenge in the complete obliteration of aneurysms. To aid in the advances of treating aneurysm stent assisted endovascular coiling was introduced to give more scaffold support to parent artery and decrease events of coil protrusion from aneurysms. Many types and generation of stents were developed. One of the most recently introduced stent is low profile visualized intraluminal support (LVIS) stent. Due to its low profile nature it can be used in 0.017-inch inner diameter microcatheter and reach small and complex vessels providing high aneurysmal neck coverage which was not possible through other traditional stent. In addition, its braided design with tantalum strands and radiopaque markers make it more visible during stent placement and post procedure stent evaluation. Despite of many advantages of LVIS stent it is related to high rate of thromboembolic complications and technical complications. Aim of this review paper was to evaluate therapeutic safety, effectiveness and feasibility of LVIS stent in endovascular coil embolization of intracranial aneurysms.
Highlights
We mainly focused on articles in english language about study related safety and effectiveness of low profile visualized intraluminal support (LVIS), articles directly comparing LVIS stent with other stent in the endovascular treatment of cerebral aneurysms
According to their study results initial Raymond 1 occlusion rate of aneurysm of ATLAS was higher (57% vs 41% LVIS, P = 0.03), significant greater rate Raymond 1 or 2 aneurysmal occlusion in follow up angiography results (ATLAS 100% vs 81% LVIS, P = 0.04) with minimum rate of in-stent stenosis for ATLAS (ATLAS 0% vs 19% LVIS, P = 0.04). As compared to those treated with LVIS stent this study demonstrates ALTAS stent has higher aneurysmal obliteration rate and lower in-stent stenosis rate
Wide necked and other complex anatomy cerebral aneurysm are still challenging for the treatment [32] [33]
Summary
Cerebral aneurysm or intracranial aneurysm, is a cerebrovascular disorder caused. U. The dilated vessels can become thin and rupture without any threatening signs resulting in subarachnoid hemorrhage which can lead to stroke, coma or death. Non-saccular aneurysms (fusiform, dolichoectatic, and dissecting aneurysms) are rare with less than 0.1% incidence [3]. Saccular or berry aneurysms is the most common form of cerebral aneurysm occurring in about 1% - 2% of the population and related to 80% - 85% of non-traumatic subarachnoid hemorrhages [4] [5]. Intracranial aneurysms are seldomly acquired lesions; a rare heredity form has been related with conditions like Marfan’s syndrome, Autosomal dominant polycystic kidney disease, Ehlers-Danlos syndrome type IV, fibromuscular dysplasia, sickle cell anemia, Moyamoya disease and brain arteriovenous malformation. Reversible risk factors like alcohol consumption, smoking and hypertension increase occurrence of aneurysm [8] [9]
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