title: Assisted coiling using LEO Baby or LVIS Jr stents: Report of six cases.
abstract: OBJECTIVE
  Endovascular treatment of broad-neck, complex cerebral aneurysms is a challenging issue. Placement of a stent over the aneurysm neck and secondary coil embolization prevents coil migration and allows dense packing of the coils. Another challenge is represented by distal aneurysms situated in small vessels. In these cases, the use of little stents, which we are going call ministents, could be a good decision. These low-profile intracranial ministents can be deployed into arteries with diameters between 1.5 and 3.10 mm and delivered through microcatheters with an internal diameter of 0.0165 inches, which allows easier navigation in small-sized, delicate vessels. We present six cases of wide-neck aneurysms, with small parental arteries less than 2.5 mm using a low-profile ministent system (LEO Baby and LVIS Jr) plus coil embolization.
  
  
  METHODS
  We retrospectively reviewed patients in whom LEO Baby or LVIS Jr stent was used for the treatment of intracranial aneurysms. Five aneurysms were treated during 2013-2014 in our service using the LEO Baby stent and one aneurysm using LVIS Jr. Stent-assisted coil embolization was performed using the jailing technique in all cases. Clinical and angiographic findings, procedural data, and follow-up are reported.
  
  
  RESULTS
  Six consecutive patients were included in this study. Four patients presented with subarachnoid hemorrhage in the subacute-chronic phase and two patients had unruptured aneurysms. Two of the six aneurysms were located at branches of the sylvian artery, one at the basilar artery, two at the anterior communicating artery, and one at the P1-P2 artery. The procedures were successful. Six-month control digital subtraction angiograms were obtained in all cases; they demonstrated complete occlusion of the aneurysms in all instances. All patients had good clinical outcomes on follow-up, as measured with the Glasgow Outcome Scale and Modified Rankin Scale.
  
  
  CONCLUSIONS
  The results of this small study show that the LEO Baby and LVIS Jr ministents could be safe and efficient for endovascular treatment of intracranial broad-neck aneurysms situated in small arteries.
authors.affiliation: Centro de Neurocirugía Endovascular, CEDIVA, Montevideo, Uruguay matiasne@hotmail.com.
authors.forename: Matías
authors.initials: M
authors.lastname: Negrotto
authors.affiliation: Centro de Neurocirugía Endovascular, CEDIVA, Montevideo, Uruguay.
authors.forename: Roberto
authors.initials: R
authors.lastname: Crosa
authors.affiliation: Centro de Neurocirugía Endovascular, CEDIVA, Montevideo, Uruguay.
authors.forename: Walter
authors.initials: W
authors.lastname: Casagrande
mesh_terms: D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D057510:Endovascular Procedures / Q000295:instrumentation*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome
keywords: Endovascular therapy; broad-neck aneurysm; small arteries