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Coil embolization of intracranial saccular aneurysms using the Low-profile Visualized Intraluminal Support (LVIS™) device

  • Interventional Neuroradiology
  • Published:
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Abstract

Introduction

The novel Low-profile Visualized Intraluminal Support (LVIS™, LVIS and LVIS Jr.) device was recently introduced for stent-supported coil embolization of intracranial aneurysms. Periprocedural and midterm follow-up results for its use in stent-supported coil embolization of unruptured aneurysms are presented herein.

Methods

In this prospective multicenter study, clinical and radiologic outcomes were analyzed for 55 patients with saccular aneurysms undergoing LVIS-assisted coil embolization between October 2012 and February 2013. Magnetic resonance angiography or digital subtraction angiography was performed to evaluate midterm follow-up results.

Results

The standard LVIS device, deployed in 27 patients, was more often used in internal carotid artery (ICA) aneurysms (n = 19), whereas the LVIS Jr. (a lower profile stent, n = 28) was generally reserved for anterior communicating artery (n = 14) and middle cerebral artery (n = 8) aneurysms. With LVIS-assisted coil embolization, successful occlusion was achieved in 45 aneurysms (81.8 %). Although no instances of navigation failure or stent malposition occurred, segmentally incomplete stent expansion was seen in five patients where the higher profile LVIS was applied to ICA including carotid siphon. Procedural morbidity was low (2/55, 3.6 %), limited to symptomatic thromboembolism. In the imaging of lesions (54/55, 98.2 %) at 6-month follow-up, only a single instances of major recanalization (1.9 %) occurred. Follow-up angiography of 30 aneurysms (54.5 %) demonstrated in-stent stenosis in 26 (86.7 %), with no instances of stent migration. Only one patient suffered late delayed infarction (modified Rankin Scale 1).

Conclusion

The LVIS device performed acceptably in stent-assisted coil embolization of non-ruptured aneurysms due to easy navigation and precise placement, although segmentally incomplete stent expansion and delayed in-stent stenosis were issues.

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Acknowledgments

This study was supported by Microvention Inc. for clinical trials of LVIS devices.

Ethical standards and patient consent

We declare that all human and animal studies have been approved by the Institutional Review Board of Seoul National University Hospital and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea

    Young Dae Cho, Chul-Ho Sohn, Mi-Sun Ko & Moon Hee Han

  2. Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea

    Hyun-Seung Kang, Jeong Eun Kim, Won-Sang Cho & Moon Hee Han

  3. Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea

    Gyojun Hwang, O-Ki Kwon & Nam-Mi Park

Authors
  1. Young Dae Cho
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  2. Chul-Ho Sohn
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  3. Hyun-Seung Kang
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  4. Jeong Eun Kim
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  5. Won-Sang Cho
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  7. O-Ki Kwon
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  8. Mi-Sun Ko
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  9. Nam-Mi Park
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  10. Moon Hee Han
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Correspondence to Moon Hee Han.

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Cho, Y.D., Sohn, CH., Kang, HS. et al. Coil embolization of intracranial saccular aneurysms using the Low-profile Visualized Intraluminal Support (LVIS™) device. Neuroradiology 56, 543–551 (2014). https://doi.org/10.1007/s00234-014-1363-x

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  • DOI: https://doi.org/10.1007/s00234-014-1363-x

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