Department of Neuroendovascular Therapy, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan.
Department of Neurosurgery, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan.
Clin Neurol Neurosurg. 2022 Jun;217:107275. doi: 10.1016/j.clineuro.2022.107275. Epub 2022 May 2.
Y-stent-assisted coil embolization is indicated for the treatment of complex intracranial bifurcation aneurysms. However, the long-term outcomes associated with this technique remain unclear. The purpose of this study was to evaluate the long-term outcomes of Y-stent-assisted coil embolization using the Low-profile Visualized Intraluminal Support Junior (LVIS Jr) device.
We retrospectively reviewed our databases to identify patients treated with Y-stent-assisted coiling using LVIS Jr. Digital subtraction angiography, silent magnetic resonance angiography (MRA), and time-of-flight MRA were performed at 1 year after the procedure. Patients also received an annual follow-up using MRA. Aneurysm occlusion status was classified into complete occlusion (CO), neck remnant (NR), and body filling (BF). Clinical outcomes were assessed using the modified Rankin Scale.
Twenty-one patients (22 aneurysms) were included in this study. All procedures were performed successfully. Immediate postprocedural angiograms showed CO in 13 aneurysms (59.1%), NR in two aneurysms (9.1%), and BF in seven aneurysms (31.8%). One-year follow-up angiograms revealed CO in 86.4% of patients. Only one patient had a major recurrence and required retreatment. The mean follow-up duration was 43.5 months. The last angiographic studies demonstrated CO in 18 aneurysms (81.8%), NR in three aneurysms (13.6%), and BF in one aneurysm (4.5%). Periprocedural and delayed complications occurred in two patients and one patient, respectively. There was no permanent morbidity or death. The modified Rankin Scale scores at last clinical follow-up were equal to those before the procedures in all patients.
Y-stent-assisted coil embolization using LVIS Jr for intracranial bifurcation aneurysms has favorable long-term angiographic and clinical outcomes.
Y 型支架辅助弹簧圈栓塞术适用于治疗复杂颅内分叉部动脉瘤。然而，该技术的长期疗效尚不清楚。本研究旨在评估使用低剖面可视化腔内支撑 Jr 装置（LVIS Jr）进行 Y 型支架辅助弹簧圈栓塞的长期疗效。
我们回顾性地检索了数据库，以确定接受 Y 型支架辅助使用 LVIS Jr 弹簧圈栓塞治疗的患者。术后 1 年进行数字减影血管造影、磁共振血管造影（MRA）和磁共振血管造影（MRA）。患者还接受了 MRA 年度随访。动脉瘤闭塞状态分为完全闭塞（CO）、颈部残余（NR）和瘤体填充（BF）。使用改良 Rankin 量表评估临床结果。
本研究纳入 21 例（22 个动脉瘤）患者。所有手术均成功完成。即刻血管造影显示 13 个动脉瘤（59.1%）完全闭塞，2 个动脉瘤（9.1%）颈部残余，7 个动脉瘤（31.8%）瘤体填充。1 年随访血管造影显示 86.4%的患者 CO。仅有 1 例患者出现重大复发，需要再次治疗。平均随访时间为 43.5 个月。最后一次血管造影研究显示 18 个动脉瘤（81.8%）完全闭塞，3 个动脉瘤（13.6%）颈部残余，1 个动脉瘤（4.5%）瘤体填充。2 例患者发生围手术期并发症，1 例患者发生迟发性并发症。无永久性残疾或死亡。末次临床随访时，所有患者改良 Rankin 量表评分与术前相同。
使用 LVIS Jr 进行颅内分叉部动脉瘤的 Y 型支架辅助弹簧圈栓塞术具有良好的长期血管造影和临床疗效。
