Radiology Department, University Hospital Saint Ivan Rilski, Bulgaria.
Interventional Neuroradiology Department, The Royal London Hospital, UK.
Neuroradiol J. 2020 Oct;33(5):377-385. doi: 10.1177/1971400920941402. Epub 2020 Jul 21.
Low-profile self-expandable stents have increased the number of intracranial aneurysms treated by endovascular means. The new low-profile visible intraluminal support device LVIS EVO (Microvention), the successor of LVIS Jr, is a self-expandable and retrievable microstent system, designed for implantation into intracranial arteries with a diameter up to 2.0 mm. In this retrospective study we aimed to elucidate the technical feasibility and clinical safety of the novel LVIS EVO stent for stent-assisted coil embolisation of intracranial aneurysms.
A single centre technical report of the first six consecutive cases of stent-assisted coil embolisation with the novel LVIS EVO stent for the treatment of unruptured or recanalised intracranial aneurysms. Records were made of basic demographics, aneurysmal characteristics, device properties and related technical details, adverse events, clinical outcomes and occlusion rates on available radiological follow-up.
Six LVIS EVO devices were successfully implanted in all subjects to treat a total number of six intracranial aneurysms. No device-related intraprocedural complications were seen. At early clinical follow-up six out of six (100%) patients had a modified Ranking score of 0-1. Early angiographic and cross-sectional radiological follow-up, available in five out of six (83.3%) of the patients confirmed unchanged aneurysmal occlusion rates. A minor, transitory neurological deficit was recorded in one of the six (16.6%) patients. Mortality was 0%.
Preliminary experience in this subset of our patients confirms a notably improved technical behaviour of the novel LVIS EVO stent system when compared to its ancestor LVIS Jr. The enhanced visibility of the stent and the refined delivery/retrieval capabilities of the stent further increase the safety margins of the devices profile, especially in cases of tortuous anatomy.
低轮廓自膨式支架增加了通过血管内方法治疗的颅内动脉瘤数量。新型低轮廓可视腔内支撑装置 LVIS EVO（Microvention）是 LVIS Jr 的继任者，它是一种自膨式可回收微支架系统，旨在植入直径达 2.0mm 的颅内动脉。在这项回顾性研究中，我们旨在阐明新型 LVIS EVO 支架在支架辅助线圈栓塞颅内动脉瘤中的技术可行性和临床安全性。
单中心技术报告，介绍了首例连续 6 例使用新型 LVIS EVO 支架进行支架辅助线圈栓塞的病例，用于治疗未破裂或再通的颅内动脉瘤。记录了基本人口统计学、动脉瘤特征、器械特性和相关技术细节、不良事件、临床结果以及可用影像学随访的闭塞率。
6 例 LVIS EVO 装置均成功植入所有患者，共治疗 6 个颅内动脉瘤。术中未发生与器械相关的并发症。在早期临床随访中，6 例患者中有 6 例（100%）的改良 Ranking 评分均为 0-1。在 5 例患者（83.3%）中进行了早期血管造影和横断面影像学随访，证实了未改变的动脉瘤闭塞率。在 6 例患者中的 1 例（16.6%）患者中记录到轻微的一过性神经功能缺损。死亡率为 0%。
在我们患者的这一小部分亚组中，初步经验证实新型 LVIS EVO 支架系统的技术性能明显优于其前身 LVIS Jr。支架的可视性增强和支架的改进输送/回收能力进一步提高了器械轮廓的安全裕度，特别是在迂曲解剖结构的情况下。
