| Objective: Our study was committed to evaluate the safety and efficacy of the Low-Profile Visualized Intraluminal Support(LVIS)in stent assisted coiling of wide-necked posterior communicating artery aneurysm.Methods: We retrospectively analyzed all patients who harbored a wide-necked posterior communicating artery aneurysm treated with LVIS stent in our department from March 2014 to May 2016.Clinical features,imaging features,strategies of endovascular treatment,intraoperative and postoperative complications,initial postoperative and follow-up angiography,discharged and follow-up status were analyzed.The outcomes were evaluated by Raymond Scale and mRS scores.SPSS19.0 was used to analyze the date,mean ± standard deviation,Fisher’s exact probabilities(α=0.05)was used in the analysis.Results: Sixty-seven patients were included.Among them,there were 28 males(41.8%)and 39 females(58.2%),with an average age of 55.6 ±11.4years.The neurological conditions were evaluated by Hunt-Hess grade,with a result that Hunt-Hess 0 in 10 patients,Hunt-Hess in Ⅰ 11 patients,Hunt-Hess in Ⅱ28 patients,Hunt-Hess Ⅲin 16 patients,Hunt-Hess Ⅳin 2 patients.The average maximum diameter of Dome ± standard deviation was 6.0±4.9 mm,average diameter of Neck ± standard deviation was 5.2±3.3 mm,the neck of 34 aneurysms were ≥ 4mm.According to the aneurysm size,46 aneurysms were small size aneurysms,13 aneurysms were middle size aneurysms,8 aneurysms were big size aneurysms.Initial angiographic results were: complete occlusion in 55 cases(82.1%,RS 1),near occlusion in 8(11.9%,RS 2),partial occlusion in 4(6.0%,RS 3).Technical success rate was 100%.Angiographic follow-up was performed in 59 patients showed that complete occlusion in 56 cases;near occlusion in 2;partial occlusion in 1,and in-stent thrombosis was found in 1 case.There was no recurrence of aneurysm,in-stent stenosis,stent displacement and parent artery occlusion.The clinical outcome showed that mRS 0 in 20 patients,mRS 1 in 22 patients,mRS 2 in 16 patients,mRS 3 in 5 patients,mRS 4 in 3 patients,mRS 5 in 1 patient.86.6% cases had good outcome.Followed up was performed 6-12 months after discharge.Forty-eight patients were achieved mRS 0,5 were achieved mRS 1,3 were achieved mRS 2,2 were achieved mRS 3,2 were achieved mRS 4,the one whose mRS was 5 was dead.Intraoperative complications were founded in 8(11.9%)patients,among of which 2(3.0%)had bleeding complications and 2(3.0%)underwent thrombosis complications,4(6.0%)had severe vessel vasospasm during procedure.The relationship between gender,aneurysm size,the size of the aneurysm neck and initial postoperative degree of occlusion was analyzed,the degree of occlusion was related to the size of aneurysm,and the complete occlusion rate in <5mm group was higher than that in≥5mm group,the difference was statistically significant.Conclusions: 1.In our study,the complete occlusion rate of LVIS stent-assisted coiling of wide-necked posterior communicating artery aneurysms was satisfactory,was higher than other types of stents.No further stenosis,stent migration and occlusion of the parent artery were observed in short-term angiographic follow-up.However,multicentric,large sample and long-term follow-up were needed.2.The complication rate was high in our study,whether the complications were related to the stent was still unknown due to small sample size.In order to reduce the incidence of sequela,we should be gentle during operation.3.The degree of occlusion was related to the size of aneurysm,and the complete occlusion rate in <5mm group was higher than that in ≥ 5mm group,the difference was statistically significant. |
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