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Case series
Preliminary experience with the use of low profile visualized intraluminal support device in basilar artery for aneurysm treatment
  1. Chuanchuan Wang,
  2. Yina Wu,
  3. Zhengzhe Feng,
  4. Jing Wang,
  5. Qiang Li,
  6. Rui Zhao,
  7. Bo Hong,
  8. Yi Xu,
  9. Qinghai Huang,
  10. Yibin Fang,
  11. Jianmin Liu
  1. Department of Neurosurgery, Changhai Stroke Center, Changhai Hospital, Second Military Medical University, Shanghai, China
  1. Correspondence to Dr Yibin Fang, Department of Neurosurgery Changhai Stroke Center, Changhai Hospital, Second Military Medical University Shanghai China ; fangyibin{at}vip.163.com and Professor Jianmin Liu, Department of Neurosurgery, Changhai Stroke Center, Changhai Hospital, Second Military Medical University, Shanghai 200433, China; chstroke{at}163.com, liu118{at}vip.163.com

Abstract

Background The low profile visualized intraluminal support (LVIS) device is being increasingly used for the treatment of intracranial aneurysms. Its application in the basilar artery (BA) has not yet been reported.

Objective To evaluate the safety and early efficacy of the LVIS device for the treatment of BA aneurysms.

Methods A prospectively maintained database was retrospectively reviewed for all patients with BA aneurysms treated by LVIS stents at our institution. Angiographic results were evaluated using the modified Raymond–Roy classification (mRRC).

Results 23 patients (mean age 52.8 years) with a BA aneurysm that was treated by LVIS stent implantation, with (n=21) or without (n=2) adjunctive coiling, were included in our study. 7 aneurysms were treated in the setting of subarachnoid hemorrhage (SAH). 10 aneurysms were located at the basilar tip, 10 at the basilar trunk, and 3 at the superior cerebellar artery. Procedure related complications developed in three patients (13%), including two perforator infarction and one worsening mass effect. Complications resulted in permanent morbidity (4%) in one case. One fatality was related to severe poor grade SAH. At a mean follow-up of 6.9 months, 13 of the 20 patients were mRRC I closure, 3 were mRRC II closure with an improvement from class IIIa, 3 were observed to be recanalized from class IIIa to IIIb, and 1 with stenting only was still patent similar to the immediate angiography.

Conclusion The LVIS stent represents a feasible and safe option for endovascular embolization of BA aneurysms. Although recanalization may occur after LVIS treatment, the mid term complete occlusion rate was acceptable.

  • aneurysm
  • basilar artery
  • endovascular treatment
  • stent

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Footnotes

  • CW and YW contributed equally.

  • Contributors CW and YW: drafting of the article and design of the data collection. JW and ZF: design of the data collection. RZ, QL, BH, YX, and QH: interpretation of the radiological results. YF and JL: revision of the article and final approval of the version to be published.

  • Funding This work was supported in part by the National Key R&D program of China (2016YFC1300700), National Natural Science Foundation of China (No 81301004), and project on research and application of effective intervention techniques for high risk population of stroke from the National Health and Family Planning Commission in China (GN-2016R0012).

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The study was approved by the ethics committee of Changhai Hospital.

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

  • Data sharing statement Additional documentation from this study is available on request to the corresponding author.