Yoo Dong Hyun, Cho Young Dae, Moon Jusun, Lee Jeongjun, Kang Hyun-Seung, Cho Won-Sang, Kim Jeong Eun, Hwang Gyojun, Kwon O-Ki, Han Moon Hee
Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
J Clin Neurosci. 2018 Apr;50:287-291. doi: 10.1016/j.jocn.2018.01.075. Epub 2018 Feb 28.
Stent-assisted coil embolization technique have broadened indications for endovascular therapy of aneurysms. The Low-profile Visualized Intraluminal Support device (LVIS) is a self-expanding, nitinol single-braid and closed-cell device introduced fairly recently. We aim to evaluate long-term outcome of LVIS device in stent-assisted coiling of intracranial aneurysms. Between October 2012 and February 2013, a total of 55 patients with unruptured wide-necked intracranial aneurysms underwent coil embolization procedures involving LVIS devices. Clinical and anatomic parameters assessed included extent of aneurysmal occlusion, stent deployment status, and delayed complications. Anatomic outcomes were evaluated via DSA, MRA, and plain radiography (PR). Three patients were lost to follow-up after 6 months, but in 37 of 52 qualifying patients (mean follow-up, 27.1 months; range, 12-36 months) post-coiling recanalization was evaluable by DSA or MRA. Only one patient (2.7%) experienced minor recanalization, all others (97.3%) showing complete occlusion. Coil configurations were consistently stable by PR in 15 other patients (mean follow-up, 34.1 months; range, 30-39 months). No migration or altered expansion of stents was evident in 30 patients with available DSA and/or PR images. Three patients (5.8%) suffered delayed cerebral ischemia without neurologic sequelae, all as transient ischemic attacks and all related to withdrawal or change of anti-platelet medications. LVIS device usage in stent-assisted coil embolization of intracranial aneurysms provides excellent long-term results in terms of safety, efficacy and durability.
支架辅助弹簧圈栓塞技术拓宽了动脉瘤血管内治疗的适应证。低轮廓可视化腔内支撑装置（LVIS）是一种近期推出的自膨胀镍钛诺单丝和闭孔装置。我们旨在评估LVIS装置在颅内动脉瘤支架辅助弹簧圈栓塞中的长期疗效。2012年10月至2013年2月，共有55例未破裂的宽颈颅内动脉瘤患者接受了涉及LVIS装置的弹簧圈栓塞手术。评估的临床和解剖学参数包括动脉瘤闭塞程度、支架置入状态和延迟并发症。通过数字减影血管造影（DSA）、磁共振血管造影（MRA）和平片摄影（PR）评估解剖学结果。3例患者在6个月后失访，但在52例符合条件的患者中的37例（平均随访27.1个月；范围12 - 36个月），弹簧圈栓塞后可通过DSA或MRA评估再通情况。只有1例患者（2.7%）出现轻微再通，其他所有患者（97.3%）显示完全闭塞。在另外15例患者（平均随访34.1个月；范围30 - 39个月）中，PR显示弹簧圈构型始终稳定。在有可用DSA和/或PR图像的30例患者中，未发现支架移位或扩张改变。3例患者（5.8%）发生延迟性脑缺血但无神经后遗症，均为短暂性脑缺血发作，且均与抗血小板药物的停用或更换有关。LVIS装置在颅内动脉瘤支架辅助弹簧圈栓塞中的应用在安全性、有效性和耐久性方面提供了优异的长期结果。
