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Case series
LVIS Blue as a low porosity stent and coil adjuvant
  1. Matthew J Koch1,
  2. Christopher J Stapleton1,
  3. Scott B Raymond2,
  4. Susan Williams2,
  5. Thabele M Leslie-Mazwi2,
  6. James David Rabinov2,
  7. Aman B Patel1
  1. 1 Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
  2. 2 Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr Matthew J Koch, Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts 02114, USA; mjkoch{at}mgh.harvard.edu

Abstract

Introduction The LVIS Blue is an FDA-approved stent with 28% metallic coverage that is indicated for use in conjunction with coil embolization for the treatment of intracranial aneurysms. Given a porosity similar to approved flow diverters and higher than currently available intracranial stents, we sought to evaluate the effectiveness of this device for the treatment of intracranial aneurysms.

Methods We performed an observational single-center study to evaluate initial occlusion and occlusion at 6-month follow-up for patients treated with the LVIS Blue in conjunction with coil embolization at our institution using the modified Raymond–Roy classification (mRRC), where mRRC 1 indicates complete embolization, mRRC 2 persistent opacification of the aneurysm neck, mRRC 3a filling of the aneurysm dome within coil interstices, and mRRC 3b filling of the aneurysm dome.

Results Sixteen aneurysms were treated with the LVIS Blue device in conjunction with coil embolization with 6-month angiographic follow-up. Aneurysms were treated throughout the intracranial circulation: five proximal internal carotid artery (ICA) (ophthalmic or communicating segments), two superior cerebellar artery, two ICA terminus, two anterior communicating artery, two distal middle cerebral artery, one posterior inferior cerebellar artery, and two basilar tip aneurysms. Post-procedurally, there was one mRRC 1 closure, five mRRC 2 closures, and 10 mRRC 3a or 3b occlusion. At follow-up, all the mRRC 1 and mRRC 3a closures, 85% of the mRRC 3b closures and 75% of the mRRC 2 closures were stable or improved to an mRRC 1 or 2 at follow-up.

Conclusions The LVIS Blue represents a safe option as a coil adjunct for endovascular embolization within both the proximal and distal anterior and posterior circulation.

  • Aneurysm
  • Flow Diverter
  • Stent
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Footnotes

  • Contributors MJK: conception, design, data collection, data analysis of the study, and primarily responsible for drafting and revising the presented manuscript. CJS: research project design, drafting and approval of final manuscript. SBR: research project design, data analysis, editing, and approval of final manuscript. SW: editing and approval of final manuscript. TML-M: editing and approval of final manuscript. JDR: data review, editing and approval of final manuscript. ABP: research project idea, article editing, and approval of final manuscript.

  • Competing interests ABP reports personal fees from Medtronic and personal fees and non-financial support from Penumbra outside the submitted work.

  • Patient consent This case series was performed in a retrospective fashion in accordance with our IRB and de-identified all materials involved in the presented study. Given the nature of the study, IRB, and number of patients involved, direct patient consent was not obtained. Care was taken to remove any non-relevant presentation information that could associate the presented study with a patient.

  • Ethics approval Massachusets General Hospital Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No unpublished data are available from this study.

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