Cho Young Dae, Sohn Chul-Ho, Kang Hyun-Seung, Kim Jeong Eun, Cho Won-Sang, Hwang Gyojun, Kwon O-Ki, Ko Mi-Sun, Park Nam-Mi, Han Moon Hee
Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea.
Neuroradiology. 2014 Jul;56(7):543-51. doi: 10.1007/s00234-014-1363-x. Epub 2014 Apr 17.
The novel Low-profile Visualized Intraluminal Support (LVIS™, LVIS and LVIS Jr.) device was recently introduced for stent-supported coil embolization of intracranial aneurysms. Periprocedural and midterm follow-up results for its use in stent-supported coil embolization of unruptured aneurysms are presented herein.
In this prospective multicenter study, clinical and radiologic outcomes were analyzed for 55 patients with saccular aneurysms undergoing LVIS-assisted coil embolization between October 2012 and February 2013. Magnetic resonance angiography or digital subtraction angiography was performed to evaluate midterm follow-up results.
The standard LVIS device, deployed in 27 patients, was more often used in internal carotid artery (ICA) aneurysms (n=19), whereas the LVIS Jr. (a lower profile stent, n=28) was generally reserved for anterior communicating artery (n=14) and middle cerebral artery (n=8) aneurysms. With LVIS-assisted coil embolization, successful occlusion was achieved in 45 aneurysms (81.8 %). Although no instances of navigation failure or stent malposition occurred, segmentally incomplete stent expansion was seen in five patients where the higher profile LVIS was applied to ICA including carotid siphon. Procedural morbidity was low (2/55, 3.6 %), limited to symptomatic thromboembolism. In the imaging of lesions (54/55, 98.2 %) at 6-month follow-up, only a single instances of major recanalization (1.9 %) occurred. Follow-up angiography of 30 aneurysms (54.5 %) demonstrated in-stent stenosis in 26 (86.7 %), with no instances of stent migration. Only one patient suffered late delayed infarction (modified Rankin Scale 1).
The LVIS device performed acceptably in stent-assisted coil embolization of non-ruptured aneurysms due to easy navigation and precise placement, although segmentally incomplete stent expansion and delayed in-stent stenosis were issues.
新型低轮廓可视化腔内支撑装置（LVIS™、LVIS和LVIS Jr.）最近被引入用于颅内动脉瘤的支架辅助弹簧圈栓塞术。本文介绍了其在未破裂动脉瘤支架辅助弹簧圈栓塞术中的围手术期及中期随访结果。
在这项前瞻性多中心研究中，分析了2012年10月至2013年2月期间接受LVIS辅助弹簧圈栓塞术的55例囊状动脉瘤患者的临床和影像学结果。采用磁共振血管造影或数字减影血管造影评估中期随访结果。
标准LVIS装置应用于27例患者，更多用于颈内动脉（ICA）动脉瘤（n = 19），而LVIS Jr.（一种低轮廓支架，n = 28）通常用于前交通动脉（n = 14）和大脑中动脉（n = 8）动脉瘤。通过LVIS辅助弹簧圈栓塞术，45个动脉瘤（81.8%）实现了成功闭塞。虽然未发生导航失败或支架位置不当的情况，但在5例将较高轮廓的LVIS应用于包括颈内动脉虹吸部在内的ICA的患者中，可见节段性支架扩张不完全。手术并发症发生率较低（2/55，3.6%），仅限于有症状的血栓栓塞。在6个月随访时对病变进行成像（54/55，98.2%），仅发生1例主要再通（1.9%）。对30个动脉瘤（54.5%）进行的随访血管造影显示，26个（86.7%）存在支架内狭窄，无支架移位情况。只有1例患者发生晚期延迟性梗死（改良Rankin量表评分为1分）。
LVIS装置在未破裂动脉瘤的支架辅助弹簧圈栓塞术中表现尚可，因其导航容易且放置精确，尽管存在节段性支架扩张不完全和延迟性支架内狭窄问题。
