Double Stent-Assisted (Y and X) Coil Embolization of Unruptured Intracranial Saccular Aneurysms using the Low-Profile Visualized Intraluminal Support Device—Single Center Experience

Purpose—To study the feasibility, safety, and durability of the dual stent-assisted coil embolization
(DSCE) technique using low-profile visualized intraluminal support (LVIS) device.
Methods—Retrospective review of our aneurysm database to identify all the patients treated with LVIS
stent-assisted embolization between July 2015 and June 2017 was performed. 15% of the patients with Yor X-configuration DSCE constituted the study population. Patient demographics, clinical presentation,
aneurysm characteristics (location, dome, and dome/neck ratio), periprocedural complications, immediate
and follow-up angiographic and clinical outcomes were reported.
Results—Twelve patients (15%) with unruptured, wide-necked branching aneurysms underwent DSCE
using LVIS Junior stents. M:F—1:11. Mean age of 60 ± 11 years. 75% (n = 9) aneurysms are located in
anterior circulation. Recurrent aneurysms were treated in 17% (n = 2). Mean aneurysm diameter was 8 ±
3.4 mm and the dome/neck ratio was 1.6 ± 0.4. Periprocedural complications were noted in 25% (n = 3;
transient in-stent thrombus = 2 and iatrogenic rupture = 1) with no clinical sequelae. Immediate aneurysm
obliteration following DSCE was noted in all (100%) patients. Mean time-of-flight (TOF) magnetic reso‐
nance angiography (MRA) follow-up was 10 ± 6 months (Range: 5–19 months). Mean clinical follow-up
was 12 ± 6 months (Range: 5–21 months). Stable neck recurrence was demonstrated in 25% (n = 3). The
average modified Rankin Score (mRS) at prestent, 24-hour poststent, and last clinical follow-up were: 0.5
(Range: 0–1), 0.75 (Range: 0–1), and 0.5 (Range: 0–1), respectively.
Conclusion—We report the first dedicated DSCE experience with LVIS Junior stents in the literature.
DSCE with LVIS Junior stents for intracranial complex wide-neck branching aneurysms is feasible, safe,
and effective with good clinical outcomes.