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LVIS 和 LVIS Jr 装置治疗颅内动脉瘤的安全性和有效性:LEPI 多中心队列研究的最终结果。

Safety and effectiveness of the LVIS and LVIS Jr devices for the treatment of intracranial aneurysms: Final results of the LEPI multicenter cohort study.

机构信息

Neuroradiology Department, University Hospital of Limoges, Dupuytren, Limoges, France.

Department of Interventional Neuroradiology, FHU NeuroVasc, Adolphe de Rothschild Foundation Hospital, Paris, France; Laboratory for Vascular Translational Science UMRS 1148, INSERM, Paris, France.

出版信息

J Neuroradiol. 2024 May;51(3):242-248. doi: 10.1016/j.neurad.2023.10.007. Epub 2023 Oct 17.

Abstract

BACKGROUND

The Low profile visualized intraluminal support (LVIS)/LVIS Jr is a self-expanding braiding stent for the treatment of intracranial aneurysm. This study is to determine the safety and effectiveness of the LVIS/LVIS Jr for the treatment of intracranial aneurysms in a real-world setting.

METHODS

This prospective, observational, multicenter study enrolled patients with unruptured, ruptured and recanalized intracranial aneurysms treated with the LVIS stents, between February 2018 to December 2019. Primary endpoint was the cumulative morbidity and mortality rate (CMMR) assessed at 12 months follow-up (FU).

RESULTS

A total of 130 patients were included (62.3 % women, mean age 55.9 ± 11.4) on an intention-to-treat basis. Four patients (3.1 %) had 2 target aneurysms; 134 total aneurysms were treated. The aneurysms were mainly located on the middle cerebral artery (41/134; 30.6 %) and the anterior communicating artery (31/134; 23.1 %). The CMMR at 1 year linked to the procedure and/or device was 4.6 % (6/130). The overall mortality was 1.5 % (2/130), none of these deaths adjudged as being linked to the procedure and/or device. All aneurysms (134/134, 100 %) were successfully treated with LVIS stent and/or other devices. At a mean FU of 16.8 months post-procedure, complete/nearly complete occlusion was achieved in 112 aneurysms (92.6 %), and only 3 patients (2.5 %) required aneurysm retreatment.

CONCLUSION

This study provides evidence that the LVIS/LVIS Jr devices are safe and effective in the treatment of complex intracranial aneurysms, with very high rates of adequate occlusion at FU. These angiographic results are stable over time with an acceptable complication rate.

TRIAL REGISTRATION

ClinicalTrial.gov under NCT03553771.

摘要

背景

低剖面可视化腔内支撑(LVIS)/LVIS Jr 是一种用于治疗颅内动脉瘤的自膨式编织支架。本研究旨在确定 LVIS/LVIS Jr 在真实环境中治疗颅内动脉瘤的安全性和有效性。

方法

本前瞻性、观察性、多中心研究纳入了 2018 年 2 月至 2019 年 12 月期间接受 LVIS 支架治疗的未破裂、破裂和再通颅内动脉瘤患者。主要终点是 12 个月随访(FU)时累积发病率和死亡率(CMMR)。

结果

共有 130 例患者(62.3%为女性,平均年龄 55.9±11.4)进行了意向治疗。4 例(3.1%)患者有 2 个靶动脉瘤;共治疗 134 个动脉瘤。动脉瘤主要位于大脑中动脉(41/134;30.6%)和前交通动脉(31/134;23.1%)。1 年内与手术和/或器械相关的 CMMR 为 4.6%(6/130)。总的死亡率为 1.5%(2/130),这些死亡均与手术和/或器械无关。所有动脉瘤(134/134,100%)均成功用 LVIS 支架和/或其他器械治疗。在术后平均 FU 16.8 个月时,112 个动脉瘤(92.6%)实现完全/近完全闭塞,仅 3 例(2.5%)需要再次治疗动脉瘤。

结论

本研究表明,LVIS/LVIS Jr 器械在治疗复杂颅内动脉瘤时是安全有效的,在 FU 时具有很高的充分闭塞率。这些血管造影结果随着时间的推移保持稳定,并发症发生率可接受。

试验注册

ClinicalTrial.gov 下的 NCT03553771。

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