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Safety and Efficacy of LVIS Jr Stent-assisted Coiling of Intracranial Aneurysms in Small-diameter Parent Arteries

A Single-center Experience

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Abstract

Objective

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.

Material and Methods

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.

Results

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.

Conclusion

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.

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Abbreviations

FD:

Flow diverter

HR-FDCT:

High-resolution flat detector computed tomography

IA:

Intracranial aneurysm

LVIS Jr:

Low-profile visualized intraluminal support junior

SAC:

Stent-assisted coiling

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Funding

This work was supported by the National Natural Science Foundation of China (grant number 81801806); Henan Provincial and Ministerial Co-construction Youth Project of Medical Science and Technology Research Plan (grant number YXKC2022029); and the Medical Science and Technology Project for Health Commission of Henan Province (grant number KYDZ2020120441).

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Authors and Affiliations

  1. Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Jianshe Road No. 1, Er qi district, Zhengzhou, Henan, China

    Shuailong Shi, Shuhai Long, Qi Tian, Zhuangzhuang Wei, Ji Ma, Jie Yang, Ye Wang, Xinwei Han & Tengfei Li

  2. Interventional Institute of Zhengzhou University, Zhengzhou, China

    Shuailong Shi, Shuhai Long, Qi Tian, Zhuangzhuang Wei, Ji Ma, Jie Yang, Ye Wang, Xinwei Han & Tengfei Li

  3. Xi’an Jiaotong University, Xi’an, China

    Fangfang Hui

Authors
  1. Shuailong Shi
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  2. Shuhai Long
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  9. Xinwei Han
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Contributions

Conceptualization: Shuailong Shi. Data curation: Qi tian. Formal analysis: Shuhai Long. Funding acquisition: Tengfei Li. Investigation: Jie Yang, Xinwei Han. Methodology: Shuailong Shi. Project administration: Ji Ma. Resources: Tengfei Li. Software: Fangfang Hui. Supervision: Ji Ma, Xinwei Han. Validation: Ye Wang. Visualization: Zhuangzhuang Wei. Writing-original draft: Shuailong Shi. Writing-review and editing: Tengfei Li.

Corresponding author

Correspondence to Tengfei Li.

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Conflict of interest

S. Shi, S. Long, F. Hui, Q. Tian, Z. Wei, J. Ma, J. Yang, Y. Wang, X. Han and T. Li certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Ethical standards

This retrospective observational study was approved by the ethics committee of our institution and complied with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Shi, S., Long, S., Hui, F. et al. Safety and Efficacy of LVIS Jr Stent-assisted Coiling of Intracranial Aneurysms in Small-diameter Parent Arteries. Clin Neuroradiol (2024). https://doi.org/10.1007/s00062-024-01397-0

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