Stent-assisted coil embolization of unruptured middle cerebral artery aneurysms using LVIS Jr. stents. (October 2020)

• Record Type: Journal Article
• Authors: Oishi, Hidenori; Fujii, Takashi; Yatomi, Kenji; Teranishi, Kohsuke; Suzuki, Kazumoto; Mishima, Yumiko; Nakajima, Shintaro
• Is Part Of: Journal of clinical neuroscience. Volume 80(2020)
• Page Start: 87
• Page End: 91
• Publication Date: 2020-10
• Subjects: Unruptured intracranial aneurysm -- Middle cerebral artery -- Stent-assisted coil embolization -- LVIS Jr.; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2020.07.070
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: MCA aneurysms are challenging for coil embolization due to their morphology. SAC of unruptured MCA aneurysms using LVIS Jr. stents is safe and efficient. Risk of complications influencing clinical outcome was very low. Anatomical results showed a high rate of complete obliteration with very low recurrence. Abstract: Authors reported the anatomical and clinical results of the stent assisted coiling (SAC) of unruptured middle cerebral artery (MCA) aneurysms using Low-profile Visualized Intraluminal Support Junior (LVIS Jr.). Forty-seven MCA aneurysms in 46 patients were the subjects of this study. The mean aneurysm size, neck width were 4.5 ± 1.8 mm, 3.0 ± 1.0 mm, respectively. Immediate anatomical outcomes were class Ⅰ in 31 (65.0%), class Ⅱ in 5 (10.6%) and class III in 11 (23.4%) patients according to Raymond-Roy classification. The latest anatomical outcomes were class Ⅰ in 33 (86.8%), class Ⅱ in 2 (5.3%) and class III in 3 (7.9%) patients. The change of aneurysm obliteration status were unchanged in 27 (71.0%), improved in 9 (23.7%) and worsen in 2 (5.3%). There were no recurrence necessitating additional treatment. Two patients suffered from angiographically evident in-stent thrombosis, but their clinical outcomes remain good. The modified Rankin scale at discharge were 0 in 45 patients, 1 in 1 patient. No patient showed clinical worsening during the clinical follow-up period at outpatient clinic (mean, 27.4 months). SAC of unruptured MCA aneurysms using LVIS Jr. provide safe and durable effect with high complete obliteration rate recurrence rate.