[Application of LVIS stents in very small intracranial aneurysms]

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2016 Aug;41(8):821-5. doi: 10.11817/j.issn.1672-7347.2016.08.008.
[Article in Chinese]

Abstract

Objective: To investigate the safety and short-term efficacy of stent on 17 patients with very small intracranial aneurysms.

Methods: A total of 17 patients with very small intracranial aneurysms were treated by LVIS stent from October 2014 to November 2015. The location, size of the aneurysms and the branch around aneurysms were evaluated by digital subtraction angiography (DSA). The metal coverage for aneurysms was enhanced by using deployment technology ("compression" mode). The safety and efficacy were assessed after operation.

Results: LVIS stents-assisted treatments for very small aneurysms were carried out in 17 cases, including 7 cases of paraclinoid aneurysms, 4 cases of posterior communicating artery aneurysms, 3 cases of anterior communicating artery aneurysms, 2 cases of carotid bifurcation aneurysms, 1 case of the superior cerebellar artery aneurysm. The stents for 17 patients with very small intracranial aneurysms were released completely (100%); Raymond grade I embolization was seen in 13 cases (76.5%); Raymond grade II embolization was seen in 4 cases (23.5%); during the follow up from a month to a year, 16 patients showed good curative effect (with the mRS score at 0-2), 1 showed poor effect (with the mRS score at 3-6), and the efficacy rate was 94.1%; no perioperative hemorrhagic and ischemic complications happened.

Conclusion: LVIS stent-assisted therapy for very small intracranial aneurysms by using deployment technology was safe and feasible, which can significantly improve the embolization rate for very small aneurysms.

目的:探讨LVIS支架辅助治疗17例颅内微小动脉瘤的安全性和疗效。方法:回顾性纳入2014年10月至2015年11月接受LVIS支架辅助血管内治疗的17例颅内微小动脉瘤患者。均经数字减影血管造影(digital subtraction angiography,DSA)充分评估动脉瘤的位置、大小、载瘤动脉及附近重要穿支情况,术中应用3D路图指导微导管到位;通过支架“推拉”技术释放支架(“压缩”方式),以增加动脉瘤颈处支架的金属覆盖率进行血管内治疗,并评估安全性和短期疗效。结果:LVIS支架辅助治疗微小动脉瘤17例,其中床突旁7例,后交通段4例,前交通段3例,颈动脉分叉部2例,后循环小脑上动脉瘤1例。17例患者均成功释放支架,共置入LVIS支架17枚,栓塞动脉瘤18个。Raymond I级栓塞13例(76.5%),Raymond II级栓塞4例(23.5%)。随访1个月至1年,疗效良好者(mRS评分0~2分) 16例,疗效不良者(mRS评分3~6分)1例,良好率为94.1%。围手术期未发生出血性及缺血性并发症。结论:通过“推拉”技术释放LVIS支架治疗微小动脉瘤安全有效,能显著提高微小动脉瘤的完全栓塞率。.

MeSH terms

  • Basilar Artery
  • Embolization, Therapeutic
  • Humans
  • Intracranial Aneurysm*
  • Safety
  • Stents*