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Current Neurovascular Research

Editor-in-Chief

ISSN (Print): 1567-2026
ISSN (Online): 1875-5739

Research Article

Feasibility and Efficacy of Low-profile Visual Intraluminal Support Device: A Single Center Five-year Experience

Author(s): Vitaliy Davidov*, Saeed Sadrameli, Virendra Desai, Jonathan Lee, Ryan Austerman, Amanda Jenson, Zain Boghani, Gavin Britz, Orlando Diaz, Richard P. Klucznik and Yi Jonathan Zhang

Volume 18, Issue 3, 2021

Published on: 10 September, 2021

Page: [279 - 286] Pages: 8

DOI: 10.2174/1567202618666210910123134

Price: $65

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Abstract

Introduction: The Low-Profile Visualized Intraluminal Support (LVIS) devices are a new generation of self-expandable, high-porosity stents approved for the treatment of large to giant wide-necked intracranial aneurysms via stent-assisted coiling. Here we report the radiographic and clinical outcomes seen with LVIS, LVIS Jr. and LVIS Blue from a single institution over a fiveyear period.

Methods: Patients with intracranial aneurysms treated by LVIS, LVIS Jr. and LVIS Blue technology over a five-year period (2012 - 2017) at our institution were retrospectively reviewed.

Results: Seventy-four patients (55 females and 19 males; average age = 59.2) with 74 aneurysms underwent embolization of intracranial aneurysms using LVIS (N = 10), LVIS Jr. (N = 47) or LVIS Blue (N = 12) devices at our institution over the study period. The most common location of treated aneurysms was the anterior communicating artery (31%), followed by the basilar artery (19%), and the middle cerebral artery (13%). The mean neck and dome sizes were 3.9±1.5mm and 6.6±3.2mm, respectively. The median follow-up time was 6 months. At the last radiographic follow- up, 93.1% of patients had complete occlusion (RR-I or OKM-D). In 5 cases (7%), the LVIS stent failed to open, requiring balloon angioplasty (N = 3) or stent recapture and use of a non-LVIS branded device (N = 2). Five patients had post-embolization infarcts, and 1 patient had an intra-operative dome rupture.

Conclusion: LVIS brand of stents is a safe, effective, and technically feasible treatment strategy for wide-neck intracranial aneurysms, with high deployment success and aneurysm obliteration rates.

Keywords: Aneurysm, device, stroke, subarachnoid, endovascular, LVIS devices.

[1]
Vernooij MW, Ikram MA, Tanghe HL, et al. Incidental findings on brain MRI in the general population. N Engl J Med 2007; 357(18): 1821-8.
[http://dx.doi.org/10.1056/NEJMoa070972] [PMID: 17978290]
[2]
Britz GW, Desai VR. Commentary: The experience with flow diverters in the treatment of posterior inferior cerebellar artery aneurysms. Oper Neurosurg (Hagerstown) 2019; 17(1): E3-4.
[http://dx.doi.org/10.1093/ons/opy367] [PMID: 30541056]
[3]
Brown MA, Parish J, Guandique CF, et al. A long-term study of durability and risk factors for aneurysm recurrence after microsurgical clip ligation. J Neurosurg 2017; 126(3): 819-24.
[http://dx.doi.org/10.3171/2016.2.JNS152059] [PMID: 27128583]
[4]
Britz GW. ISAT trial: coiling or clipping for intracranial aneurysms? Lancet 2005; 366(9488): 783-5.
[http://dx.doi.org/10.1016/S0140-6736(05)67190-5] [PMID: 16139637]
[5]
Molyneux AJ, Kerr RSC, Yu L-M, et al. International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet 2005; 366(9488): 809-17.
[http://dx.doi.org/10.1016/S0140-6736(05)67214-5] [PMID: 16139655]
[6]
Edgell RC. Overview of newer stent devices for aneurysm treatment [presentation for the society of vascular and international neurology]. 2014. Available from: . http://www.svin.org/files/ Edgell_Over.pdf.
[7]
Feng Z, Fang Y, Xu Y, et al. The safety and efficacy of low profile visualized intraluminal support (LVIS) stents in assisting coil embolization of intracranial saccular aneurysms: a single center experience. J Neurointerv Surg 2016; 8(11): 1192-6.
[http://dx.doi.org/10.1136/neurintsurg-2015-012090] [PMID: 26747876]
[8]
Samaniego EA, Abdo G, Hanel RA, Lima A, Ortega-Gutierrez S, Dabus G. Endovascular treatment of PICA aneurysms with a Low-profile Visualized Intraluminal Support (LVIS Jr) device. J Neurointerv Surg 2016; 8(10): 1030-3.
[http://dx.doi.org/10.1136/neurintsurg-2015-012070] [PMID: 26534868]
[9]
Matsuda Y, Chung J, Keigher K, Lopes D. A comparison between the new Low-profile Visualized Intraluminal Support (LVIS Blue) stent and the Flow Redirection Endoluminal Device (FRED) in bench-top and cadaver studies. J Neurointerv Surg 2018; 10(3): 274-8.
[http://dx.doi.org/10.1136/neurintsurg-2017-013074] [PMID: 28939583]
[10]
Koch MJ, Stapleton CJ, Raymond SB, et al. LVIS Blue as a low porosity stent and coil adjuvant. J Neurointerv Surg 2018; 10(7): 682-6.
[http://dx.doi.org/10.1136/neurintsurg-2017-013608] [PMID: 29331948]
[11]
Fiorella D, Arthur A, Boulos A, et al. Final results of the US humanitarian device exemption study of the low-profile visualized intraluminal support (LVIS) device. J Neurointerv Surg 2016; 8(9): 894-7.
[http://dx.doi.org/10.1136/neurintsurg-2015-011937] [PMID: 26391016]
[12]
Iosif C, Piotin M, Saleme S, et al. Safety and effectiveness of the Low Profile Visualized Intraluminal Support (LVIS and LVIS Jr) devices in the endovascular treatment of intracranial aneurysms: results of the TRAIL multicenter observational study. J Neurointerv Surg 2018; 10(7): 675-81.
[http://dx.doi.org/10.1136/neurintsurg-2017-013375] [PMID: 29175829]
[13]
Cekirge HS, Saatci I. A new aneurysm occlusion classification after the impact of flow modification. AJNR Am J Neuroradiol 2016; 37(1): 19-24.
[http://dx.doi.org/10.3174/ajnr.A4489] [PMID: 26316566]
[14]
Mascitelli JR, Moyle H, Oermann EK, et al. An update to the Raymond-Roy Occlusion Classification of intracranial aneurysms treated with coil embolization. J Neurointerv Surg 2015; 7(7): 496-502.
[http://dx.doi.org/10.1136/neurintsurg-2014-011258] [PMID: 24898735]
[15]
O’kelly CJ, Krings T, Fiorella D, Marotta TR. A novel grading scale for the angiographic assessment of intracranial aneurysms treated using flow diverting stents. Interv Neuroradiol 2010; 16(2): 133-7.
[http://dx.doi.org/10.1177/159101991001600204] [PMID: 20642887]
[16]
Cho SH, Jo WI, Jo YE, Yang KH, Park JC, Lee DH. Bench-top comparison of physical properties of 4 commercially-available self-expanding intracranial stents. Neurointervention 2017; 12(1): 31-9.
[http://dx.doi.org/10.5469/neuroint.2017.12.1.31] [PMID: 28316867]
[17]
Poncyljusz W, Biliński P, Safranow K, et al. The LVIS/LVIS Jr. stents in the treatment of wide-neck intracranial aneurysms: multicentre registry. J Neurointerv Surg 2015; 7(7): 524-9.
[http://dx.doi.org/10.1136/neurintsurg-2014-011229] [PMID: 24827067]
[18]
Su W, Zhang Y, Chen J, Liu J, Rajah G, Yang X. 225 intracranial aneurysms treated with the Low-profile Visualized Intraluminal Support (LVIS) stent: a single-center retrospective study. Neurol Res 2018; 40(6): 445-51.
[http://dx.doi.org/10.1080/01616412.2018.1457608] [PMID: 29683412]
[19]
Tian Z, Zhang M, Li G, et al. Hemodynamic differences by increasing low profile visualized intraluminal support (LVIS) stent local compaction across intracranial aneurysm orifice. Interv Neuroradiol 2020; 26(5): 557-65.
[http://dx.doi.org/10.1177/1591019920952903] [PMID: 32830566]
[20]
Wang X, Xing H, Cai J, et al. The safety and efficacy of the LVIS stent for the treatment of ruptured intracranial aneurysms within 24 hours: A multicenter retrospective study. Clin Neurol Neurosurg 2020; 197: 106117.
[http://dx.doi.org/10.1016/j.clineuro.2020.106117] [PMID: 32745790]
[21]
King B, Vaziri S, Singla A, Fargen KM, Mocco J. Clinical and angiographic outcomes after stent-assisted coiling of cerebral aneurysms with Enterprise and Neuroform stents: a comparative analysis of the literature. J Neurointerv Surg 2015; 7(12): 905-9.
[http://dx.doi.org/10.1136/neurintsurg-2014-011457] [PMID: 25352581]
[22]
Gory B, Klisch J, Bonafé A, et al. Solitaire AB stent-assisted coiling of wide-necked intracranial aneurysms: short-term results from a prospective, consecutive, European multicentric study. Neuroradiology 2013; 55(11): 1373-8.
[http://dx.doi.org/10.1007/s00234-013-1277-z] [PMID: 24057085]

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