Overlapped Stenting Combined with Coiling for Blood Blister-like Aneurysms: Comparison of Low-profile Visualized Intraluminal Support (LVIS) Stent and Non-LVIS Stent.

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Overlapped Stenting Combined with Coiling for Blood Blister-like Aneurysms: Comparison of Low-profile Visualized Intraluminal Support (LVIS) Stent and Non-LVIS Stent.

World Neurosurg. 2017 Mar 27;:

Authors: Zhu D, Fang Y, Yang P, Zhang P, Chen L, Huang Q, Liu J

Abstract
OBJECTIVE: To evaluate the safety and efficacy of overlapped stenting for blood blister-like aneurysms (BBAs) and to compare the outcomes between LVIS and non-LVIS stents.
METHODS: A retrospective review of the aneurysm database identified 37 patients carrying internal carotid artery (ICA) BBAs treated by overlapped stenting in our institution from June 2013 to June 2016. The clinical characteristics and angiographic results were reviewed.
RESULTS: Overlapped stenting combined with coiling were applied in 37 BBAs, including LVIS stents in 18 cases and non-LVIS stents in 19. For the LVIS group, angiographic results at 3-24 months were complete occlusion in 15 cases (83.3%), improved in 2 cases (11.1%), and recanalized in 1 case (5.6%). The modified Rankin Scale (mRs) scores at 3-36 months follow-up were 0-2 in 15 cases (83.3%) and 3-6 in 3 cases (16.7%). For the non-LVIS group, angiographic results at 3-46 months were complete occlusion in 12 cases (63.2%) and recanalized in 7 cases (36.8%). Clinical outcomes at 6-58 months were mRS scores of 0-2 in 17 cases (89.5%) and 3-6 in 2 cases (10.5%). Use of the LVIS stent was less likely to result in recanalization (OR=0.10, 95% CI: 0.01-0.93, P=0.042) than the non-LVIS stent. The LVIS group had a lower average number of stents than did the don-LVIS group (2.2 vs 2.6, P=0.016). In terms of complication rate (11.1% vs 5.3%, P=0.604), good outcome rate (83.3% vs 89.5%, P=0.660), and immediate angiographic result (P=0.424), no statistically significant difference between the two groups was found.
CONCLUSIONS: Overlapped LVIS stenting combined with coiling is feasible and safe for BBAs. Overall, the LVIS stent provided less risk of BBA recurrence compared with the non-LVIS stent and did not increase the risk of procedure-related complications.

PMID: 28359923 [PubMed - as supplied by publisher]

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