J Neurointensive Care.  2019 Oct;2(2):52-57. 10.32587/jnic.2019.00178.

Preliminary Experience of Lvis Blue in the Internal Carotid Artery for The Treatment Of Wide-Necked Intracranial Aneurysms

• Kim JH
• Jang CK
• Lee JW
• Park KY
• Chung J

• KMID: 2555021
• DOI: http://doi.org/10.32587/jnic.2019.00178

Abstract

Objective
A new Low-profile Visualized Intraluminal Support device (LVIS Blue) is a braided stent that provides a higher degree of metal coverage and increasingly used for the stent-assisted coiling of intracranial aneurysms. In the present study, our preliminary experience of using LVIS Blue in the internal carotid artery (ICA) for the treatment of wide-necked intracranial aneurysms was reported.
Methods
This retrospective review included patients with ICA aneurysms prospectively collected from our database who were treated using LVIS Blue at our institution from September 2017 to December 2018. Angiographic results, clinical outcomes, and technical issues were evaluated.
Results
A total of 22 patients with unruptured wide-necked ICA aneurysms were treated using LVIS Blue. Seven aneurysms were located in the superior hypophyseal artery, 4 in posterior communicating artery, 4 in ICA dorsal wall, 3 in ICA bifurcation, 2 in ophthalmic artery, 1 in ICA ventral wall, and 1 in ICA lateral wall. During the procedure, suboptimal positioning and foreshortening of the stent occurred in 1 patient each. Immediate postembolization angiography showed complete obliteration in 13 patients (59.1%), residual neck in 4 (18.2%), and residual aneurysm in 5 patients (22.7%). Follow-up angiographic results showed complete obliteration in 19 patients (86.4%). In-stent stenosis (> 50% stenosis) was not observed on follow-up angiography. In addition, morbidity or mortality did not occur.
Conclusion
The LVIS Blue may be feasible and safe for stent-assisted coiling in ICA aneurysms. Foreshortening, suboptimal deployment, and difficulty to open proximal ends may be considerable technical issues in the tortuous ICA.

Keyword

Intracranial aneurysm; Wide-necked aneurysm; LVIS Blue; Stent-assisted coiling