Aydin Kubilay, Puthuran Mani, Onal Yilmaz, Barburoglu Mehmet, Chandran Arun, Berdikhojayev Mynzhylky, Gravino Gilbert, Senturk Yunus Emre, Aygun Serhat, Velioglu Murat, Sencer Serra
Department of Interventional Radiology, Koc University Hospital, Topkapi, Istanbul, Turkey.
Department of Neuroradiology, Istanbul University, Istanbul Faculty of Medicine, Capa, Istanbul, Turkey.
Neurosurgery. 2023 Apr 1;92(4):827-836. doi: 10.1227/neu.0000000000002283. Epub 2022 Dec 12.
The Low Profile Visible Intraluminal Support EVO (LVIS EVO) is a self-expandable braided stent, which was recently introduced for the treatment of intracranial aneurysms. Full visibility of the stent and a relatively high metal coverage ratio are the unique features of the LVIS EVO.
To assess the safety, efficacy, and midterm durability of LVIS EVO stent-assisted coiling for the treatment of wide-necked intracranial aneurysms.
The endovascular databases were reviewed to identify patients treated with LVIS EVO-assisted coiling. The technical success and immediate clinical/angiographic outcomes were assessed. Periprocedural and delayed complications were evaluated. The follow-up angiographic/clinical outcomes were investigated. The preprocedural/follow-up neurological statuses were assessed with the modified Rankin Scale.
One hundred three aneurysms in 103 patients (63 females) with a mean age of 54.9 ± 11.3 years were included. The mean maximum sac diameter was 6.2 ± 2.9 mm. The procedural technical success rate was 100%. Immediate postprocedural angiography showed complete occlusion in 77.7%. The mean duration of the angiographic follow-up was 8.8 ± 3.6 months. Follow-up angiography showed complete aneurysm occlusion in 89% of the 82 patients with angiographic follow-up. Recanalization was observed in 7.3% of 82 patients. Two patients (2.4%) required retreatment. In addition, 8.7% of the patients had at least 1 complication, and 2.9% of the patients developed a permanent morbidity. All patients had mRS scores ≤2.
The results of this study demonstrate that SAC with LVIS EVO is a relatively safe, efficient, and durable treatment for wide-necked and complex intracranial aneurysms.
低轮廓腔内可视支架EVO(LVIS EVO)是一种自膨式编织支架,最近被引入用于治疗颅内动脉瘤。该支架的独特之处在于具有完全可视性以及相对较高的金属覆盖率。
评估LVIS EVO支架辅助弹簧圈栓塞术治疗宽颈颅内动脉瘤的安全性、有效性及中期耐久性。
回顾血管内介入数据库,以确定接受LVIS EVO辅助弹簧圈栓塞术治疗的患者。评估技术成功率以及即刻临床/血管造影结果。评估围手术期及延迟并发症。调查随访血管造影/临床结果。采用改良Rankin量表评估术前/随访时的神经功能状态。
纳入103例患者(63例女性)的103个动脉瘤,平均年龄54.9±11.3岁。动脉瘤最大囊径平均为6.2±2.9mm。手术技术成功率为100%。术后即刻血管造影显示77.7%完全闭塞。血管造影随访平均时长为8.8±3.6个月。82例接受血管造影随访的患者中,随访血管造影显示89%动脉瘤完全闭塞。82例患者中有7.3%观察到再通。2例患者(2.4%)需要再次治疗。此外,8.7%的患者发生至少1种并发症,2.9%的患者出现永久性神经功能缺损。所有患者改良Rankin量表评分均≤2分。
本研究结果表明,LVIS EVO辅助弹簧圈栓塞术治疗宽颈及复杂颅内动脉瘤是一种相对安全、有效且持久的治疗方法。