Background and Purpose Stent-assisted coiling is a feasible and effective treatment of ruptured aneurysms and is increasingly used in acutely ruptured aneurysms. The Low Profile Visualized Intraluminal Support (LVIS) stent is a self-expanding, retrievable, single-wire braid microstent system. Very small numbers of acutely ruptured aneurysms are reported. We aimed to evaluate the safety and effectiveness of the LVIS stent for the treatment of ruptured intracranial aneurysms within 24 hours of ictus compared with treatment between 25 and 72 hours.
Methods This was a multicenter retrospective study of acutely ruptured intracranial aneurysms treated with the LVIS stents. Acutely ruptured aneurysms were treated with LVIS stent-assisted coiling within 72 hours after the initial subarachnoid hemorrhage. 110 consecutive patients with ruptured aneurysms underwent LVIS stent-assisted coiling from January 2017 to December 2017. The timing of treatment was grouped into the treatment within 24 hours of ictus and the treatment between 25 and 72 hours. Baseline characteristics, perioperative complications, angiographic results, and clinical outcomes were compared between the two groups.
Results A total of 101 patients with 101 acutely ruptured aneurysms were included in this study. 16(15.8%) patients had multiple aneurysms. 49 (48.5%) patients underwent stent-assisted coiling within 24 hours. There were no statistically significant differences in age, sex, WFNS grade, Fisher grade, aneurysm location, and aneurysm characteristics. The intraoperative complications occurred in 7 patients (6.9%) and postoperative ischemia occurred in 5 patients (5%). Perioperative complications occurred in 2 (4.1%) patients treated within 24 hours compared with those in 10 (19.2%) treated between 25–72 hours (P=0.019). The multivariate logistic regression analysis of predictor of perioperative complications showed that preoperative WFNS grade (P=0.017) and timing of treatment (P=0.042) were independent predictors of perioperative complications after stenting. The total aneurysm occlusion rate was 90.1% on immediate angiography and was 96.4% at the last follow-up. Clinical outcomes and follow-up aneurysm occlusion did not significantly differ between within 24 hours and 25–72hours groups.
Conclusions Our results showed that the timing of treatment was an independent predictor of perioperative complications after stent-assisted coiling of acutely ruptured aneurysms. The LVIS stent-assisted coiling may be safe and effective in the treatment of acutely ruptured intracranial aneurysms within 24 hours with low perioperative complication rates.
Disclosures B. Zhao: None. X. Wang: None. Y. Chen: None. J. Cai: None. D. Jin: None. J. Wan: None. Y. Pan: None. G. Mao: None.
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