Long term safety and effectiveness of LVIS Jr for treatment of intracranial aneurysms- a Canadian Multicenter registry

Author:

McEachern James123,Iancu Daniela4,van Adel Brian5,Drake Brian6,Kaderali Zul7,Spirou Michael4,Lesiuk Howard6,Weill Alain4,Roy Daniel4,Raymond Jean4,Hadziomerovic Isabel S8,Shankar Jai123ORCID

Affiliation:

1. Department of Radiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada

2. Department of Human Anatomy and Cell Science, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada

3. Biomedical Engineering, Price Faculty of Engineering, University of Manitoba, Winnipeg, MB, Canada

4. Department of Radiology, Centre hospitalier de’Universite de Montreal, Montreal, Canada

5. Division of Neurology, McMaster University, Hamilton, Canada

6. Division of Neurosurgery, University of Ottawa, Ottawa, Canada

7. Division of Neurosurgery, University of Manitoba, Winnipeg, Canada

8. Faculty of Science, McGill University, Montreal, Canada

Abstract

Background The Low-profile Visible Intraluminal Support device (LVIS Jr) has become a commonly used intracranial stent for the treatment of intracranial aneurysms. However long-term stability and effectiveness remains to be seen. The purpose of the study was to assess the long-term efficacy, safety and durability of LVIS Jr. in a retrospective multicenter registry. Methods Patients with saccular aneurysms treated at centers across Canada using LVIS Jr for intracranial aneurysms were included in this retrospective registry between the dates of January 2013 and April 2019. Self reported outcomes were collected and used to assess both perioperative and long term safety and effectiveness. Both univariate and multivariate analysis were performed. Results Total of 196 patients (132 Women; mean age of 57.6 years) underwent endovascular aneurysm treatment with at least 1 LVIS Jr. stent. Mean aneurysm dome size was 7.4 mm, and mean neck size of 4.3 mm. Mean clinical and imaging follow up were 950 and 899 days respectively. Class I/II was achieved in 85% on long term follow up. Periprocedural morbidity and mortality was 4.6% and 2% and additional delayed morbidity and mortality was 3% and 2.5%. Aneurysm size >10 mm was independent predictor of periprocedural complication (OR 2.59, p = 0.048) while an increased dome to neck ratio >1.5 was independent predictor of increased delayed complications (OR 3.99, p = 0.02). Conclusion The LVIS Jr. intracranial stent is an effective device in the treatment of intracranial aneurysms. Satisfactory long term occlusion rates can be achieved safely with stent-assisted coil embolization.

Publisher

SAGE Publications

Subject

Immunology

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