Clinical Study Of LVIS Stent-assisted Coil Embolization In Wide-necked Intracranial Aneurysms

Purpose Intracranial aneurysm is a major cause of spontaneous subarachnoid hemorrhage,accounting for about 75-80%,overall mortality rate is about 45%(32%-67%),therefore intracranial aneurysm should be respond actively.traditional surgical method was intracranial aneurysm clipping,the surgery can be performed under direct vision,but it had high difficulty and risk,Aneurysm Trial International Subarachnoid Hemorrhage(ISAT)on 2005 confirmed the follow-up results,it was showed that compared with the craniotomy clipping,endovascular embolization can reduce the relative and absolute risk to treatment intracranial aneurysm patients,so endovascular treatment technique had more rapid development,it has become the preferred mode of operation for intracranial aneurysm.But for wide-necked aneurysms,because the aneurysm cannot be dense embolism caused recurrence or coil easy go into the parent artery caused thrombosis events,so it was considered the difficulty of endovascular treatment in recent years.with the development of balloon and stent assisted technique and double microcatheter technique,wide-necked aneurysms endovascular treatment effect has been significantly improved.Stent assisted coil embolization has become the main treatment for wide-necked aneurysms.In this study,we reviewed the intracranial wide-necked aneurysms which received treatment in my department.To investigate the safety and short-term efficacy for LVIS stent-assisted coil embolization in wide-necked intracranial aneurysms.Methods A retrospective analysis from September 2015 to September 2016 the Armed Police General Hospital Nerve Vascular Surgery using LVIS stent assisted embolization for the treatment of 31 patients with 32 cases of intracranial aneurysms,summarize and analyze the patients condition,imaging features,statistical procedure complications and immediate postoperative angiography results,postoperative follow-up of 3 months to 12 months,according to the Raymond classification,modified Rankin scale(m RS),valued the techniques and clinical application of evaluation score and radiographic results.Results The 34 LVIS stents were successfully inserted and released.There were 21 LVIS stents and 13 LVIS Jr stents.1 LVIS / LVIS Jr stent:stents were deployed successfully,1 cases of open proximal stent poor adherence is a bit poor,had not special treatment,postoperative and follow-up without complications.The morphology of the other stents was satisfactory and the attachment was good.2 Efficacy of LVIS/LVIS Jr stents in the treatment of aneurysms Angiography immediately after the operation showed that 29 patients with complete embolization were found,and there were only 2 residual aneurysms neck,and the remaining aneurysm cavity was 1.3 Safety of LVIS/LVIS Jr stents in the treatment of aneurysms Intraoperative aneurysm rupture occurred in 2 cases,stent thrombosis occurred in the distal end of the stent in 2 cases,and in the other 1 cases,the stent opened poorly;4 3-12 months follow-up results All patients were followed up and no aneurysm rupture was found.3 months after the operation,the m RS score showed that 0-1 score was divided into 26,2-3 score was 3cases,3-5 score was 2 cases.5 Imaging follow-up All patients were followed up for 3-12 months underwent cerebral angiography(DSA),average 7 months,in 29 cases of postoperative dense embolism in patients with postoperative examination showed no recurrence,1 cases of aneurysm neck residual residual aneurysm neck was disappeared,the other 1 cases the residual aneurysm neck and 1 case of aneurysm cavity residual showed no obvious change in six months of follow-up.Conclusion LVIS stent-assisted coil embolization in wide-necked intracranial aneurysms is safe and short-term efficacious.But follow-up time is short,it still need further studied to evaluate LVIS stent long-term efficacy.