Alghamdi Faisal, Mine Benjamin, Morais Ricardo, Scillia Pietro, Lubicz Boris
Department of Neuroradiology, Erasme University Hospital, 808 Route de Lennik, 1070, Bruxelles, Belgium.
Department of Radiology, Cliniques du Sud Luxembourg, Clinique Saint-Joseph, Arlon, Belgium.
Neuroradiology. 2016 Jul;58(7):665-71. doi: 10.1007/s00234-016-1668-z. Epub 2016 Mar 5.
The Low-profile Visualized Intraluminal Support (LVIS) Junior stent is dedicated for endovascular treatment of wide-neck intracranial aneurysms located on small-diameter vessels (2-3.5 mm). This study reports midterm clinical and anatomical results of this device.
This study was approved by authors' ethical committees. A retrospective review of our prospectively maintained database identified all patients treated by this stent in three institutions. Technical issues and immediate and mid-term anatomical and clinical outcomes were evaluated.
Forty patients (30 women/10 men, mean age of 55 years) with 43 aneurysms were identified. Mean aneurysm diameter was 5.6 mm (range, 2-13 mm). In all patients, treatment was successful and the stent could be precisely placed. There were three procedure-related complications, one stent thrombosis and two aneurysm ruptures, leading to immediate morbidity in one patient. Delayed ischemic events occurred in three patients including two transient attacks and one permanent deficit. The overall permanent morbidity rate was thus 5 %. No mortality occurred. Immediate aneurysm occlusion consisted of 36 complete occlusions (83.7 %), five neck remnants (11.6 %), and two incomplete occlusions (4.7 %). Twenty-seven patients (29 aneurysms) and 11 patients (11 aneurysms) had a 12- and 6-month angiographic follow-up, respectively. Final anatomical results included 36 complete occlusions (90 %) and four neck remnants (10 %). Two minor recanalizations were seen but did not require retreatment. Non-significant intrastent stenosis occurred in 7/40 followed-up cases (17.5 %).
The LVIS Junior stent appears safe and effective for endovascular treatment of wide-neck intracranial aneurysms located on small vessels. Midterm results show high rates of adequate and stable occlusion.
低轮廓可视化腔内支撑（LVIS）Junior支架专门用于血管内治疗位于小直径血管（2 - 3.5毫米）上的宽颈颅内动脉瘤。本研究报告了该装置的中期临床和解剖学结果。
本研究经作者伦理委员会批准。对我们前瞻性维护的数据库进行回顾性分析，确定了在三个机构接受该支架治疗的所有患者。评估了技术问题以及即刻和中期的解剖学和临床结果。
确定了40例患者（30名女性/10名男性，平均年龄55岁），共43个动脉瘤。动脉瘤平均直径为5.6毫米（范围2 - 13毫米）。所有患者治疗均成功，支架可精确放置。有3例与手术相关的并发症，1例支架血栓形成和2例动脉瘤破裂，导致1例患者即刻出现并发症。3例患者发生延迟性缺血事件，包括2次短暂发作和1次永久性神经功能缺损。因此，总体永久性并发症发生率为5%。无死亡病例。即刻动脉瘤闭塞包括36例完全闭塞（83.7%）、5例颈部残留（11.6%）和2例不完全闭塞（4.7%）。分别有27例患者（29个动脉瘤）和11例患者（11个动脉瘤）进行了12个月和6个月的血管造影随访。最终解剖学结果包括36例完全闭塞（90%）和4例颈部残留（10%）。观察到2例轻微再通，但无需再次治疗。在40例随访病例中有7例（17.5%）出现非显著性支架内狭窄。
LVIS Junior支架对于血管内治疗位于小血管上的宽颈颅内动脉瘤似乎是安全有效的。中期结果显示充分且稳定闭塞的比例较高。
