title: Coil embolization of intracranial saccular aneurysms using the Low-profile Visualized Intraluminal Support (LVIS™) device.
abstract: BACKGROUND
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea.
authors.forename: Young Dae
authors.initials: YD
authors.lastname: Cho
authors.forename: Chul-Ho
authors.initials: CH
authors.lastname: Sohn
authors.forename: Hyun-Seung
authors.initials: HS
authors.lastname: Kang
authors.forename: Jeong Eun
authors.initials: JE
authors.lastname: Kim
authors.forename: Won-Sang
authors.initials: WS
authors.lastname: Cho
authors.forename: Gyojun
authors.initials: G
authors.lastname: Hwang
authors.forename: O-Ki
authors.initials: OK
authors.lastname: Kwon
authors.forename: Mi-Sun
authors.initials: MS
authors.lastname: Ko
authors.forename: Nam-Mi
authors.initials: NM
authors.lastname: Park
authors.forename: Moon Hee
authors.initials: MH
authors.lastname: Han
mesh_terms: D000368:Aged; D002408:Catheters, Indwelling; D002533:Cerebral Angiography / Q000295:instrumentation* / Q000379:methods; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008904:Miniaturization; D011474:Prosthesis Design; D015641:Radiography, Interventional / Q000295:instrumentation* / Q000379:methods
references.citation: J Neurosurg. 2009 Jan;110(1):35-9
references.pmid: 18976057
references.citation: Minim Invasive Neurosurg. 2011 Feb;54(1):21-8
references.pmid: 21506064
references.citation: Neuroradiology. 2013 Nov;55(11):1373-8
references.pmid: 24057085
references.citation: Neurosurgery. 2013 Apr;72(4):617-29; discussion 628-9
references.pmid: 23277371
references.citation: Neurosurgery. 2010 Dec;67(6):1523-32; discussion 1532-3
references.pmid: 21107183
references.citation: Neurosurgery. 2009 Mar;64(3 Suppl):ons130-4; discussion ons134
references.pmid: 19240562
references.citation: J Korean Neurosurg Soc. 2010 Dec;48(6):485-9
references.pmid: 21430973
references.citation: Neurosurgery. 2011 Oct;69(4):908-13; discussion 913-4
references.pmid: 21670718
references.citation: Neurosurgery. 2006 Jul;59(1):34-42; discussion 34-42
references.pmid: 16823298
references.citation: Clin Radiol. 2013 Mar;68(3):256-63
references.pmid: 23017739
references.citation: J Neurointerv Surg. 2015 Apr;7(4):297-302
references.pmid: 24651613
references.citation: AJR Am J Roentgenol. 2013 Apr;200(4):872-8
references.pmid: 23521463
references.citation: Neuroradiology. 2008 Dec;50(12):991-8
references.pmid: 18807024
references.citation: J Neurointerv Surg. 2013 Mar;5(2):157-60
references.pmid: 22345109
references.citation: Lancet. 2000 Dec 2;356(9245):1895-7
references.pmid: 11130387
references.citation: Interv Neuroradiol. 2007 Sep;13(3):255-69
references.pmid: 20566117
references.citation: Neuroradiology. 2013 Mar;55(4):459-65
references.pmid: 23358878
references.citation: Clin Radiol. 2014 Feb;69(2):e63-70
references.pmid: 24286934
references.citation: AJNR Am J Neuroradiol. 2012 Apr;33(4):649-54
references.pmid: 22194381
references.citation: Stroke. 2001 Sep;32(9):1998-2004
references.pmid: 11546888
references.citation: Stroke. 2010 Jan;41(1):110-5
references.pmid: 19959540
references.citation: AJNR Am J Neuroradiol. 2013 Jun-Jul;34(6):1203-8
references.pmid: 23348764
references.citation: Cardiovasc Revasc Med. 2009 Jan-Mar;10(1):17-22
references.pmid: 19159850
references.citation: J Biomech Eng. 1997 May;119(2):206-12
references.pmid: 9168397
references.citation: J Neurointerv Surg. 2013 Nov;5 Suppl 3:iii79-iii82
references.pmid: 23172541
references.citation: Neurosurgery. 2000 Jul;47(1):107-13; discussion 113-5
references.pmid: 10917353
references.citation: Neurosurgery. 2013 Mar;72(3):390-6
references.pmid: 23208057