Potential advantages and limitations of the Leo stent in endovascular treatment of complex cerebral aneurysms
Section snippets
Population
Between January 2007 and June 2009, consecutive 28 patients with 28 complex cerebral aneurysms were treated with the Leo stent to evaluate its potential advantages and disadvantages (Table1). The study consisted of 15 women and 13 men with a mean age of 52 years (range, 25–78 years). Seventeen patients had a history of subarachnoid hemorrhage, 8 patients had incidental aneurysms, 1 patient presented with complex recanalization from a previously coiled aneurysm, 1 presented with occulomotor
Results
Selective embolization was successfully performed and resulted in an excellent clinical outcome in all patients. In all but 2 patients (7.1%), the Vasco catheter was very easily navigated and positioned with a Synchro 14 microguidewire past the aneurysm neck. These 2 patients presented with 2 ICA aneurysms that was located on a very tortuous ICA. A previous attempt of endovascular treatment with the Leo stent failed because the delivery catheter appeared too stiff and Neuroform stent was used.
Patient 7
A 28-year-old woman presented with grade 1 SAH. The patient underwent conventional angiography and three-dimensional angiography showed a wide-necked aneurysm of the mid-basilar artery. The aneurysm was treated with the Leo stent (Fig. 1). A 3.5-mm × 25-mm Leo stent was placed. Then, a microcatheter was gently advanced through the stent struts, and coils were delivered. Final angiographic control showed a complete occlusion of the aneurysm, and the patient was discharged 3 days later.
Patient 8
A
Discussion
This study shows that the Leo stent is a very useful tool for endovascular treatment of complex cerebral aneurysms. This stent has three major advantages: (1) two radiopaque markers along its total length make it very visible; (2) the delivery system that allows easy navigation and precise placement; and (3) the possibility to reposition the stent whenever necessary. However, the currently available stent has two relatively limiting characteristics: (1) in-stent thrombosis caused by stent
Conclusion
Our study is the largest reported single-center experience with the Leo stent. It shows that this device is a very useful tool for the treatment of complex cerebral aneurysms. This stent has three major advantages: (1) two radiopaque markers along its total length make it very visible; (2) the delivery system that allows easy navigation and precise placement; and (3) the possibility to reposition the stent whenever necessary. However, it has also two relatively limiting characteristics: (1)
Conflict of interest
We declare that we had no conflict of interest.
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2014, Journal of Stroke and Cerebrovascular DiseasesCitation Excerpt :In the first few years, they were the only choices and were mostly used. However, they have limitations, such as the impossibility to reposition the stent when it is partially delivered, a low radial force and some deployment difficulties for Neuroform stent,10 and the need for progressively larger profile and stiffer delivery catheters for Leo stent.11 The new generation of Neuroform stent (Neuroform 3) was reported to have undergone several technical modifications to improve deliverability, but there are still reports of failure of stent deployment, and the stent is still unretractable.12
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