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Canadian Registry of LVIS Jr for Treatment of Intracranial Aneurysms (CaRLA)
  1. Jai Jai Shiva Shankar1,
  2. Aiman Quateen2,
  3. Alain Weill3,
  4. Donatella Tampieri4,
  5. Maria Del Pilar Cortes5,
  6. Robert Fahed3,
  7. Satya Patro2,
  8. Zul Kaderali6,
  9. Cheemun Lum2,
  10. Howard Lesiuk7,
  11. Uzair Ahmed8,
  12. Lissa Peeling8,
  13. Michael E Kelly9,
  14. Daniela Iancu2
  1. 1Department of Diagnostic Imaging, QE II Health Sciences Centre, Halifax, Nova Scotia, Canada
  2. 2Division of Neuroradiology, Department of Diagnostic Imaging, The Ottawa Hospital, Ottawa, Canada
  3. 3Department of Radiology, Centre hospitalier de l'Université de Montréal (CHUM), Hopital Notre-Dame, Montreal, Quebec, Canada
  4. 4Departments of Radiology, Neurology, and Neurosurgery, Montreal Neurological Hospital and Institute, Montreal, Quebec, Canada
  5. 5Department of Radiology, Montreal Neurological Hospital and Institute, Montreal, Quebec, Canada
  6. 6Section of Neurosurgery, Health Sciences Centre, Winnipeg, Canada
  7. 7Department of Neurosurgery, The Ottawa Hospital, Ottawa, Canada
  8. 8Department of Neurosurgery, University of Saskatchewan, Saskatoon, Canada
  9. 9Departments of Neurosurgery, Medical Imaging, Biomedical Engineering, & Anatomy and Cell Biology, University of Saskatchewan, Saskatoon, Canada
  1. Correspondence to Dr Jai Jai Shiva Shankar, Department of Diagnostic Imaging, QE II Health Sciences Centre, 1796 Summer St, Halifax, Nova Scotia, Canada B3H 1E6; shivajai1{at}gmail.com

Abstract

Introduction Stents reduce the rate of angiographic recurrence of intracranial aneurysms. The newest stent for intracranial use is the Low-profile Visible Intraluminal Support device (LVIS Jr).

Objective To assess the efficacy of the new stent in a multicenter retrospective registry.

Materials and method Centers across Canada using LVIS Jr were contacted and asked to participate in a retrospective registry of consecutive patients treated with LVIS Jr for intracranial aneurysms between January 2013 and July 2015.

Results A total of 102 patients, with saccular aneurysms in 100 patients (72 women; age range 21–78 years; mean 56.0 years; median 57.5 years) were treated with a LVIS Jr stent. The mean maximum diameter of the dome and neck of the aneurysm and dome to neck ratios were 8.3 mm±7.7 mm, 4.4 mm±1.9 mm, and 1.86±1.22, respectively. Angiographic complications arose in 23 patients, clinical complications in 9 patients, and only 3% of permanent neurological deficits occurred. Death occurred in 1 patient, unrelated to the stent. The ruptured status of the aneurysms (OR=3.29; p=0.046) and use of LVIS Jr for bailout (OR=2.54; p=0.053) showed a trend towards significant association with higher angiographic complications. At the last available follow-up, 68 class I, 20 class II, and 12 class III results were seen.

Conclusions The LVIS Jr stent is a safe and effective device for stent-assisted coiling, with 3% permanent neurological complications. Stent-assisted coiling continues to be technically challenging in cases of ruptured aneurysms and bailout situations.

  • Aneurysm
  • Coil
  • Device
  • Intervention
  • Stent

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