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Original research
Y-configuration stenting for coiling of wide-neck bifurcation aneurysms using Low-profile Visualized Intraluminal Support Junior
  1. Keun Young Park1,
  2. Byung Moon Kim2,
  3. Dong Joon Kim2,
  4. Joonho Chung1,
  5. Jae Whan Lee1
  1. 1 Department of Neurosurgery, Severance Hospital Stroke Center, Yonsei University College of Medicine, Seoul, Republic of Korea
  2. 2 Department of Radiology, Severance Hospital Stroke Center, Yonsei University College of Medicine, Seoul, Republic of Korea
  1. Correspondence to Dr Byung Moon Kim, Department of Radiology, Interventional Neuroradiology Severance Stroke Center, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; bmoon21{at}hanmail.net

Abstract

Background Little has been reported about the feasibility and durability of a Low-profile Visualized Intraluminal Support Junior (LVIS Jr) Y-stenting device for wide-neck bifurcation aneurysms.

Purpose To evaluate the feasibility and durability of LVIS Jr Y-stenting for coiling of unruptured wide-neck bifurcation aneurysms.

Methods We identified patients in whom LVIS Jr Y-stenting was attempted for unruptured wide-neck bifurcation aneurysms from a prospectively maintained registry of a referral hospital. Procedural success rate, treatment-related morbidity, and clinical and angiographic outcomes were retrospectively assessed.

Results LVIS Jr Y-stenting was attempted for a total of 21 aneurysms in 21 patients (mean age 60±8.9 years; M:F=6:15): nine basilar artery, six anterior communicating artery, four middle cerebral artery, one internal carotid artery, and one vertebrobasilar fenestration aneurysms. The mean dome and neck size were 7.9±2.7 mm and 5.7±1.8 mm, respectively. All attempts were successful. Treatment-related morbidity occurred in one individual with a modified Rankin Scale (mRS) score of 2. Immediate postprocedural angiograms showed complete occlusion in 15 (71.4%) and neck remnant in 6 (28.6%) patients. All 21 patients had good outcomes (mRS score 0–2) for a mean of 12 months' follow-up (range 6–27 months); mRS score 0 in 20 patients and mRS score 2 in one patient, respectively. Follow-up imaging over a mean of 11 months (range 6–18 months) was available in 18 patients (85.7%). All aneurysms showed complete occlusion at follow-up.

Conclusions LVIS Jr Y-stenting and coiling for wide-neck bifurcation aneurysms seems to be feasible with acceptable safety and to provide durable aneurysm occlusion for wide-neck bifurcation aneurysms.

  • coil
  • aneurysm
  • stent

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Footnotes

  • Contributors Substantial contribution to the conception or design of the work: BMK. Acquisition, analysis, or interpretation of the data for the work: KYP, BMK, DJK, JC, and JWL. Drafting the work or revising it critically for important intellectual content: KYP and BMK. Final approval of the version to be published: KYP, BMK, DJK, JC, and JWL. Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: KYP, BMK, DJK, JC, and JWL.

  • Funding This work was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (HC15C1056).

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Severance Hospital institutional review board.

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

  • Data sharing statement The relevant anonymised patient level data are available on reasonable request from the authors.