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Original research
Effects of acute angle, proximal bending, and distal bending in the deployment vessels on incomplete low-profile visualized intraluminal support (LVIS) expansion: an in vitro study
  1. Hiroyuki Ikeda1,2,
  2. Ryotaro Otsuka1,
  3. Daisuke Uesaka3,
  4. Noritaka Sano1,
  5. Sadaharu Torikoshi1,
  6. Makoto Hayase1,
  7. Hiroki Toda1
  1. 1 Neurosurgery, Japanese Red Cross Fukui Hospital, Fukui, Japan
  2. 2 Neurosurgery, Kurashiki Central Hospital, Kurashiki, Okayama, Japan
  3. 3 Radiology, Japanese Red Cross Fukui Hospital, Fukui, Japan
  1. Correspondence to Dr Hiroyuki Ikeda, Neurosurgery, Kurashiki Central Hospital, Kurashiki, Okayama, Japan; rocky{at}kuhp.kyoto-u.ac.jp

Abstract

Background A low-profile visualized intraluminal support (LVIS) device may incompletely expand during stent deployment in tortuous vessels. However, the cause of incomplete expansion remains uninvestigated. We aimed to examine in vitro the factors causing incomplete expansion in LVIS deployment by using various vessel models.

Methods A linear model group was created by connecting linear silicone tubes (inner diameter 4 mm) at both sides of the LVIS deployment vessel (inner diameter 4 mm) with different curvature angles of 10–140° at 10° intervals. For comparison, proximal and distal bending model groups were created, both with 90° bending on the proximal/distal larger curvature side of the deployment vessel. A single operator macroscopically deployed an LVIS (4.5×32 mm) four times in each model and 56 times in each group.

Results In each model group the LVIS deployment vessel with a narrow curvature angle incompletely expanded. Incomplete expansion occurred significantly more frequently in the distal bending model group (34%, 19/56) compared with that in the linear model group (14.3%, 8/56; p<0.001), as well as in the proximal bending model group (59%, 33/56) compared with that in the distal bending model group (p<0.05). Compared with the linear model group, the proximal bending model group had a significantly reduced angle between the LVIS and the direction of the LVIS pushing force, but no significant change was found in the distal bending model group compared with that in the linear model group.

Conclusions Factors such as acute angle, distal bending, and proximal bending of the deployment vessel can cause incomplete LVIS expansion.

  • stent
  • aneurysm
  • catheter
  • device

Data availability statement

Data are available upon reasonable request. The datasets analyzed in this manuscript are not publicly available. Requests to access the datasets should be directed to rocky@kuhp.kyoto-u.ac.jp.

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Data availability statement

Data are available upon reasonable request. The datasets analyzed in this manuscript are not publicly available. Requests to access the datasets should be directed to rocky@kuhp.kyoto-u.ac.jp.

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Footnotes

  • Correction notice This article has been corrected since it was published Online First. A typo was removed from the article.

  • Contributors HI: planning, conduct, and reporting of the work described in the article. RO, DU, NS, ST, MH, and HT: reporting of the work described in the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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

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