Department of Neurosurgery, Changhai Stroke Center, Changhai Hospital, Second Military Medical University, Shanghai, China.
J Neurointerv Surg. 2019 Apr;11(4):405-410. doi: 10.1136/neurintsurg-2018-014393. Epub 2018 Nov 10.
The low profile visualized intraluminal support (LVIS) device is being increasingly used for the treatment of intracranial aneurysms. Its application in the basilar artery (BA) has not yet been reported.
To evaluate the safety and early efficacy of the LVIS device for the treatment of BA aneurysms.
A prospectively maintained database was retrospectively reviewed for all patients with BA aneurysms treated by LVIS stents at our institution. Angiographic results were evaluated using the modified Raymond-Roy classification (mRRC).
23 patients (mean age 52.8 years) with a BA aneurysm that was treated by LVIS stent implantation, with (n=21) or without (n=2) adjunctive coiling, were included in our study. 7 aneurysms were treated in the setting of subarachnoid hemorrhage (SAH). 10 aneurysms were located at the basilar tip, 10 at the basilar trunk, and 3 at the superior cerebellar artery. Procedure related complications developed in three patients (13%), including two perforator infarction and one worsening mass effect. Complications resulted in permanent morbidity (4%) in one case. One fatality was related to severe poor grade SAH. At a mean follow-up of 6.9 months, 13 of the 20 patients were mRRC I closure, 3 were mRRC II closure with an improvement from class IIIa, 3 were observed to be recanalized from class IIIa to IIIb, and 1 with stenting only was still patent similar to the immediate angiography.
The LVIS stent represents a feasible and safe option for endovascular embolization of BA aneurysms. Although recanalization may occur after LVIS treatment, the mid term complete occlusion rate was acceptable.
低轮廓可视化腔内支撑（LVIS）装置越来越多地用于治疗颅内动脉瘤。其在基底动脉（BA）中的应用尚未见报道。
评估 LVIS 装置治疗 BA 动脉瘤的安全性和早期疗效。
回顾性分析了在我院接受 LVIS 支架治疗的所有 BA 动脉瘤患者的前瞻性维护数据库。使用改良 Raymond-Roy 分级（mRRC）评估血管造影结果。
本研究共纳入 23 例（平均年龄 52.8 岁）BA 动脉瘤患者，其中 21 例（n=21）或不（n=2）辅助弹簧圈治疗采用 LVIS 支架植入治疗。7 例动脉瘤在蛛网膜下腔出血（SAH）背景下治疗。10 个动脉瘤位于基底动脉尖，10 个位于基底干，3 个位于小脑上动脉。3 例（13%）患者出现与操作相关的并发症，包括 2 例穿支梗死和 1 例症状加重。1 例并发症导致永久性残疾（4%）。1 例死亡与严重不良分级 SAH 有关。平均随访 6.9 个月后，20 例患者中有 13 例 mRRC Ⅰ级闭塞，3 例 mRRC Ⅱ级闭塞，从 IIIa 级改善，3 例从 IIIa 级再通至 IIIb 级，1 例仅支架治疗的患者仍与即刻血管造影相似保持通畅。
LVIS 支架是治疗 BA 动脉瘤的一种可行且安全的选择。尽管 LVIS 治疗后可能会再通，但中期完全闭塞率是可以接受的。
