Abstract
Purpose: The low-profile visualized intraluminal support junior (LVIS Jr.) is a new generation low-profile braided stent. Our aim was to evaluate the safety and efficacy of the LVIS Jr. in the stent-assisted coiling of unruptured middle cerebral artery (MCA) aneurysms. This was a multicenter retrospective study. Patient demographics, aneurysm characteristics, procedural details, complications, and the results of clinical and imaging follow-up were analyzed. Four centers participated in the study. A total of 162 consecutive patients with 162 unruptured MCA aneurysms were included for the analysis. The mean aneurysm size was 7.6 mm (range 2 to 37 mm) and 97.5% were wide-necked. Immediate postprocedural angiograms showed Raymond-Roy class 1 in 118 (72.8%), class 2 in 23 (14.2%), and class 3 in 21 patients (13%). Periprocedural complications occurred in 14 patients (8.6%). There were no procedure-related deaths. Follow-up imaging at 12–18 months post-procedure showed Raymond–Roy class 1 in 132 (81.5%), class 2 in 17 (10.5%), and class 3 in 13 patients (8%). There were 3 cases of in-stent stenosis (1.9%). All 162 patients had good clinical outcome (mRS score 0–2) at 90 days post-procedure. Stent-assisted coiling of unruptured MCA aneurysms with the LVIS Jr. stent is safe and effective, with high immediate and long-term total occlusion rates.
Highlights
Endovascular coiling is an established method for treating unruptured intracranial aneurysms [1,2,3,4,5]
A total of 162 patients with 162 unruptured middle cerebral artery (MCA) aneurysms treated with the stent-assisted coiling were included in the study
To the best of our knowledge, we have reported the largest series of unruptured MCA aneurysms treated with the stent-assisted coiling
Summary
Endovascular coiling is an established method for treating unruptured intracranial aneurysms [1,2,3,4,5]. When the aneurysm morphology is complex, it is often a technically challenging procedure, even for an experienced interventional radiologist. This is especially true for middle cerebral artery (MCA) aneurysms. These aneurysms, in many cases, are wide-necked and, commonly, the branch vessels arise from the aneurysm sac. The endovascular coiling of MCA aneurysms is associated with a higher complication rate when compared to the treatment of more proximal lesions [6].
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