Objective This study retrospectively compared the clinical and angiographic outcomes of treating cerebral aneurysms with Neuroform (NEU), Enterprise (EP), and Low-profile Visualized Intraluminal Support (LVIS/LVIS Jr) stents.
Materials and methods We conducted a retrospective analysis of a procedural database. All aneurysm procedures using any of the three types of self-expanding nitinol stents (NEU, EP and LVIS/LVIS Jr) were included. Intra-procedure complications, post-procedure complications, and angiographic results (Raymond–Roy grade scale, RRGS) were analyzed retrospectively. A multivariate logistic regression analysis was conducted to identify predictors of intra-procedure and post-procedure complications.
Results Two hundred and forty-three aneurysms in 229 patients treated with stent-assisted coiling were included (NEU group: 109 aneurysms; EP group: 61 aneurysms; LVIS/LVIS Jr: 73 aneurysms). The LVIS/LVIS Jr group was associated with the lowest rate of initial complete occlusion (RRGS I: 47.9%; 35/73). Follow-up showed the proportion of RRGS I increased for all stent groups but was greatest in the LVIS/LVIS Jr group. Overall, 17 intra-procedural complications were seen in 229 patients (7.4%) and 15 post-procedural complications were found in 198 patients at follow-up (7.6%), with no differences between stent groups. Thrombotic events were the most common complications and occurred in 13 patients (13/229, 5.7%).
Conclusions All three types of stents used to treat cerebral aneurysms with unfavorable neck were safe and effective, providing suitable support for the coil mass. LVIS/LVIS Jr promotes better progressive aneurysm complete occlusion than the other two stents but seems to cause more common intra-procedural stent-related thrombotic events and fewer post-procedural complications.
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Contributors Design and revising of the work: AT. Drafting the work and analysis, interpretation of data: JW. Acquisition of data: JV, AS, IC, RDT, JL. Final approval of the version to be published: AT. Agreement to be accountable for all aspects of the work: all authors.
Competing interests AS: Penumbra: Consulting, Honorarium, Speaker Bureau; Pulsar Vascular: Consulting, Honorarium, Speaker Bureau; Microvention: Consulting, Honorarium, Speaker Bureau, Research; Stryke:r Consulting, Honorarium, Speaker Bureau. RDT, AT, IC: Codman: Consulting, Honorarium, Speaker Bureau, Research funding; Covidien: Consulting, Honorarium, Speaker Bureau; Penumbra: Consulting, Honorarium, Speaker Bureau, Research grants; Microvention: Consulting, Honorarium, Speaker Bureau, Research grants; Blockade: Stock, Consulting, Honorarium, Speaker Bureau; Pulsar Vascular: Stock, Consulting, Honorarium, Speaker Bureau, Research; Medtronic: Consulting, Honorarium, Speaker Bureau.
Ethics approval Medical University of South Carolina IRB.
Provenance and peer review Not commissioned; externally peer reviewed.