Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Jianshe Road No. 1, Er qi district, Zhengzhou, Henan, China.
Interventional Institute of Zhengzhou University, Zhengzhou, China.
Clin Neuroradiol. 2024 Sep;34(3):587-595. doi: 10.1007/s00062-024-01397-0. Epub 2024 Mar 7.
To investigate the safety and efficacy of LVIS Jr stent-assisted coiling (SAC) of intracranial aneurysms (IAs) in small-diameter parent arteries and determine the factors influencing incomplete aneurysm occlusion.
Clinical and imaging data of 130 patients with IAs in small-diameter parent arteries that were treated with LVIS Jr SAC were retrospectively analyzed. Stent apposition was evaluated by high-resolution flat detector CT, and aneurysm embolization density was evaluated using 2D-DSA. Perioperative complications were recorded. Multivariate logistic regression analyses were performed to determine possible factors for incomplete aneurysm occlusion.
In this study, 130 patients (60 and 70 patients with ruptured and unruptured aneurysms, respectively) were successfully treated with LVIS Jr SAC. Immediate digital subtraction angiography (DSA) showed that the aneurysm occlusion was Raymond-Roy class I, II, IIIa, and IIIb in 93 (71.5%), 24 (18.5%), 8 (6.2%), and 5 (3.8%) cases, respectively. There were three cases of acute in-stent thrombosis and two cases of severe vasospasm observed during the perioperative period. The 6‑month follow-up angiograms indicated that complete aneurysm occlusion in 122 patients was 79.5% (97/122). Multivariate logistic regression analyses showed that an aneurysm size > 10.0 mm, parent artery mean diameter < 2.0 mm, and incomplete stent apposition at the aneurysm neck were possible risk factors for incomplete aneurysm occlusion.
The LVIS Jr SAC is effective for managing IAs in small-diameter parent arteries. An aneurysm size > 10.0 mm, parent artery mean diameter < 2.0 mm, and incomplete stent apposition at the aneurysm neck are possible risk factors for incomplete aneurysm occlusion.
研究 LVIS Jr 支架辅助弹簧圈栓塞（SAC）治疗小直径载瘤动脉颅内动脉瘤（IA）的安全性和有效性，并确定影响不完全动脉瘤闭塞的因素。
回顾性分析 130 例小直径载瘤动脉 LVIS Jr SAC 治疗的 IA 患者的临床和影像学资料。采用高分辨率平板探测器 CT 评估支架贴壁情况，二维数字减影血管造影（2D-DSA）评估动脉瘤栓塞密度。记录围手术期并发症。采用多变量逻辑回归分析确定不完全动脉瘤闭塞的可能因素。
本研究中，130 例患者（破裂和未破裂动脉瘤患者各 60 例和 70 例）成功接受 LVIS Jr SAC 治疗。即刻数字减影血管造影（DSA）显示 93 例（71.5%）、24 例（18.5%）、8 例（6.2%）和 5 例（3.8%）患者的动脉瘤闭塞分别为 Raymond-Roy 分级Ⅰ、Ⅱ、Ⅲa 和Ⅲb 级。围手术期发现 3 例急性支架内血栓形成和 2 例严重血管痉挛。6 个月随访时，122 例患者完全闭塞，占 79.5%（97/122）。多变量逻辑回归分析显示，动脉瘤直径>10.0mm、载瘤动脉平均直径<2.0mm 和瘤颈支架贴壁不完全是不完全动脉瘤闭塞的可能危险因素。
LVIS Jr SAC 治疗小直径载瘤动脉 IA 是有效的。动脉瘤直径>10.0mm、载瘤动脉平均直径<2.0mm 和瘤颈支架贴壁不完全是不完全动脉瘤闭塞的可能危险因素。
