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LVIS Jr ‘shelf’ technique: an alternative to Y stent-assisted aneurysm coiling
  1. Elizabeth Hai Yen Du1,
  2. Jai Jai Shiva Shankar2
  1. 1Department of Diagnostic Radiology, Dalhousie University, Halifax, Nova Scotia, Canada
  2. 2Division of Neuroradiology, Department of Diagnostic Imaging, QE II Health Sciences Center, Halifax, Nova Scotia, Canada
  1. Correspondence to Dr Jai Jai Shiva Shankar, Division of Neuroradiology, Department of Diagnostic Imaging, QE II Health Sciences Centre, Halifax, Nova Scotia, Canada B3H 1E6; shivajai1{at}gmail.com

Abstract

Wide-necked bifurcation intracranial aneurysms have traditionally not been amenable to coil embolization with the use of a single stent due to the high risk of coil prolapse. Y-configuration double stent-assisted coil embolization (‘Y-stenting’) of this aneurysm type has been shown to have generally good clinical outcomes, although the technique is complex with various challenges described in the literature. The compliant and flexible closed-cell design of braided stents such as the LVIS Jr allows for the creation of a ‘shelf’ across the aneurysm neck sufficient to prevent coil prolapse. We describe this novel ‘shelf’ technique and present a small case series of LVIS Jr stent-assisted wide-necked bifurcation intracranial aneurysm coiling in eight patients. Our small, albeit important, case series demonstrates that the ‘shelf’ technique is feasible and safe with very good short-term clinical and angiographic outcomes, and may obviate the need for Y-stenting.

  • Aneurysm
  • Coil
  • Device
  • Intervention
  • Stent

https://doi.org/10.1136/neurintsurg-2015-012246

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    Footnotes

    • Contributors JJSS made substantial contributions to the conception and design of the work, acquisition, analysis, and interpretation of data for the work, had a major role in drafting the work and revising it critically for important intellectual content, approved the version to be published, and agrees 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. EHYD made substantial contributions to the acquisition, analysis, and interpretation of data for the work, had a major role in drafting the work and revising it critically for important intellectual content, approved the version to be published, and agrees 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.

    • Competing interests JS is a proctor for LVIS Jr stents in Canada and has received an honorarium for his proctorship. He has also received a Microvention education grant.

    • Ethics approval Ethics approval was obtained from the Nova Scotia Health Authority Research Ethics Board.

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