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Case series
Endovascular treatment of PICA aneurysms with a Low-profile Visualized Intraluminal Support (LVIS Jr) device
  1. Edgar A Samaniego1,2,
  2. German Abdo2,
  3. Ricardo A Hanel3,
  4. Andrey Lima3,
  5. Santiago Ortega-Gutierrez1,
  6. Guilherme Dabus4
  1. 1Division of Interventional Neuroradiology/Endovascular Neurosurgery, Department of Neurology, Neurosurgery and Radiology, University of Iowa, Iowa City, USA
  2. 2Departamento de Neuroradiologia Intervencionista, Hospital Eugenio Espejo, Quito, Ecuador
  3. 3Baptist Neurological Institute, Jacksonville, Florida, USA
  4. 4Department of NeuroInterventional Surgery, Miami Cardiac & Vascular Institute and Baptist Neuroscience Center, Miami, Florida, USA
  1. Correspondence to Dr Edgar A Samaniego, Division of Interventional Neuroradiology/Endovascular Neurosurgery, Department of Neurology, 200 Hawkins Dr 2007, Iowa City, IA 52242, USA; edgarsama{at}gmail.com

Abstract

Objective To describe the treatment of posterior inferior cerebellar artery (PICA) aneurysms with the Low-profile Visualized Intraluminal Support Device (LVIS Jr) stent.

Materials and methods The databases of three institutions were retrospectively reviewed. Patients who underwent endovascular treatment of PICA aneurysms using a reconstructive technique where the LVIS Jr stent was totally or partially deployed into the PICA were included in the analysis. Clinical presentation, aneurysm and PICA sizes, procedural complications, and clinical and angiographic follow-up information was recorded and analyzed.

Results Seven patients who underwent endovascular treatment of PICA aneurysms with an LVIS Jr stent were identified. Four aneurysms were treated in the acute phase of subarachnoid hemorrhage (SAH). There were no symptomatic complications. One patient had spasm distal to the stent as a result of mechanical straightening of the vessel. One patient was treated in the acute phase of SAH and required a gycoprotein IIb/IIIa inhibitor after the stent was implanted. This patient needed to be re-treated to complete embolization. All patients had good clinical outcomes (Glasgow Outcome Scale 5). No in-stent stenosis or occlusion was seen on short-term angiographic follow-up and the aneurysms were occluded.

Conclusions This small series suggests that the use of a reconstructive technique with the LVIS Jr stent for the treatment of PICA aneurysms is feasible, safe and effective in the short term.

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