Meta-analysis Demonstrating The Safety And Efficacy Of LVIS Stent VS Other Stents In Coil Embolization Of Cerebral Aneurysm

Background: Cerebral or intracranial aneurysm a leading cause of subarachnoid hemorrhage.It was initially treated with open surgical clipping but as rapid development of technology a less invasive endovascular coiling technique of aneurysm revolutionized the treatment.Due to tortuous anatomy of parent artery and complicated morphology and location of aneurysm there is ongoing challenges in the complete obliteration of aneurysms.To aid in the advances of treating aneurysm stent assisted endovascular coiling was introduced to give more scaffold support to parent artery and decrease events of coil protrusion from aneurysms.Many types and generation of stents were developed.One of the most recently introduced stent is Low profile visualized intraluminal stent.Due to its low-profile nature it can be used in 0.017-inch inner diameter microcatheter and reach small and complex vessels providing high aneurysmal neck coverage which was not possible through other traditional stent.In addition,its braided design with tantalum strands and radiopaque markers making it more visible during stent placement and post procedure stent evaluation.Despite of many advantages of LVIS stent it is related to high rate of thromboembolic complications and technical complications.Objective: Aim of this paper was to evaluate and compare therapeutic safety,effectiveness and feasibility of LVIS stent vs other stent in endovascular coil embolization of intracranial aneurysms.METHOD: A systematic search was conducted electronically up to the year 2017 using specific eligibility criteria.Two reviewers completed article search and were entered into the computerized sheet for meta-analysis.Revman 5.3 was used for meta-analysis.All values were extracted as total and events.Odds ratio and the corresponding 95% confidence intervals(95% CI)were used as a measure of effect size.RESULT: IN total 5 studies there was no significant difference between Initial and follow up obliteration rate between LVIS and other groups.Regarding complication also there were no significant difference.However,LVIS stent group had a significantly lower likelihood of aneurysm recurrence compared to other group.Heterogeneity:(P = 0.30);I2 = 18%Test for overall effect: Z = 2.24(P = 0.02)OR = 0.40;95% confidence intervals [CI]: [0.18-0.89]Conclusion: Further Randomized control trial and comparison study of LVIS stent VS other stent with higher population and longer follow-up is required to verify LVIS advantages on the endovascular coiling treatment intracranial aneurysms.