title: Overlapped Stenting Combined with Coiling for Blood Blister-Like Aneurysms: Comparison of Low-Profile Visualized Intraluminal Support (LVIS) Stent and Non-LVIS Stent.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of overlapped stenting for blood blister-like aneurysms (BBAs) and to compare the outcomes between Low-profile Visualized Intraluminal Support (LVIS) and non-LVIS stents.
  
  
  METHODS
  A retrospective review of the aneurysm database identified 37 patients with intracranial carotid artery 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 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 modified Rankin Scale 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 (odds ratio 0.10, 95% confidence interval 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 non-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 2 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.
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Deyuan
authors.initials: D
authors.lastname: Zhu
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Yibin
authors.initials: Y
authors.lastname: Fang
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Pengfei
authors.initials: P
authors.lastname: Yang
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Hong
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Qinghai
authors.initials: Q
authors.lastname: Huang
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China. Electronic address: chstroke@163.com.
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000628:therapy*; D015901:Angiography, Digital Subtraction; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D003131:Combined Modality Therapy; D000072226:Computed Tomography Angiography; D004621:Embolization, Therapeutic / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult
keywords: Blood blister-like aneurysm; LVIS stent; Overlapped stenting