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J Stroke Cerebrovasc Dis · Feb 2019
Endovascular Treatment of Ruptured Tiny Intracranial Aneurysms with Low-Profile Visualized Intraluminal Support Device.
- Pei Wu, Pinar Eser Ocak, Dianhong Wang, Umut Ocak, Shancai Xu, Yuchen Li, Tongyu Zhang, and Huaizhang Shi.
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China. Electronic address: wupei163@163.com.
- J Stroke Cerebrovasc Dis. 2019 Feb 1; 28 (2): 330-337.
BackgroundRuptured tiny intracranial aneurysms (TIAs) have been challenging both for endovascular and neurosurgical interventions. Thus, we aimed to evaluate the safety and efficacy of low-profile visualized intraluminal support (LVIS) device in the treatment of ruptured TIAs (rTIAs).Material And MethodsAmong 761 intracranial aneurysms which were treated either surgically or endovascularly, 32 rTIAs underwent stent-assisted coiling with LVIS device between 2014 and 2017. Patient data were reviewed retrospectively. Clinical and radiological outcomes were recorded at discharge and mid-term follow-up.ResultsMean patient ages were 53 ± 14.5 years. Mean aneurysm size was 2.28 ± .53 mm (range, 1-2.9 mm) with a mean dome:neck ratio of 1.08 (range, .75-2.14). The LVIS stents were successfully implanted in all patients. Mean follow-up period was 9.3 ± 1.9 months (range, 6-15 months). Immediate angiographic evaluation demonstrated complete occlusion in 13 (40.6%) patients, while neck remnant and residual sac were observed in 12 (37.5%) and 7 (21.9%), respectively. All patients had moderate disability (mRS 2-3) at discharge. Number of aneurysms with complete occlusion significantly increased and 82.1% of the patients (23 of 28) demonstrated complete occlusion at follow-up (P = .0015). Among these, 27 had good outcome (mRS 0-1; 96.9%) with significant improvement compared to discharge (P = .0001). There was no recurrence or enlargement of the residual aneurysms. Additionally, there were no procedure-related complications except the one (3.6%) showing asymptomatic stenosis of the posterior cerebral artery in follow-up imagings.ConclusionsStent-assisted coiling of rTIAs with LVIS device provides high rates of technical success and complete occlusion at mid-term follow-up with an excellent safety profile.Copyright © 2018. Published by Elsevier Inc.
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