Endovascular Treatment of Ruptured Middle Cerebral Artery Aneurysms With a Low-Profile Visualized Intraluminal Support Device
Objective: Stenting in ruptured middle cerebral artery (MCA) aneurysms was reported with a high perioperative complication rate. However, the treatment devices and physician's experience have continued to evolve. We performed this retrospective study to evaluate the safety and efficacy of LVIS...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2020.631745/full |
| _version_ | 1818911496445362176 |
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| author | Gaici Xue Yu Zhou Peng Liu Qiao Zuo Pengfei Yang Yibin Fang Qiang Li Rui Zhao Yi Xu Bo Hong Qinghai Huang Jianmin Liu |
| author_facet | Gaici Xue Yu Zhou Peng Liu Qiao Zuo Pengfei Yang Yibin Fang Qiang Li Rui Zhao Yi Xu Bo Hong Qinghai Huang Jianmin Liu |
| author_sort | Gaici Xue |
| collection | DOAJ |
| description | Objective: Stenting in ruptured middle cerebral artery (MCA) aneurysms was reported with a high perioperative complication rate. However, the treatment devices and physician's experience have continued to evolve. We performed this retrospective study to evaluate the safety and efficacy of LVIS stent-assisted coiling for ruptured MCA aneurysms.Methods: Patients with acutely ruptured MCA aneurysms treated between November 2014 and October 2019 were retrospectively reviewed. Clinical and angiographic data of those treated with LVIS stents were collected from a prospectively maintained database.Results: A total of 40 patients with 40 ruptured MCA aneurysms were enrolled, which comprised 26.3% (40/152) of all the ruptured MCA aneurysms at the same time. All stents were successfully deployed except for one (2.5%), which had a poor stent opening. Ischemic procedure-related complications were encountered in three patients (7.5%). One patient died of complications related to high-grade SAH on admission. Follow-up (mean 15.9 months) angiography was performed for 36 patients, which showed 33 (91.7%) aneurysms were completely occluded, 1 (2.8%) was improved, 1 (2.8%) was stable, and 1 (2.8%) was recanalized. Clinical follow-up (mean 29.6 months) was available for all survived patients, which showed 38 (95.0%) patients had favorable neurologic outcomes (mRS score 0–2), and 2 (5.0%) patients had poor neurologic outcomes.Conclusion: The use of LVIS stents is feasible, safe, and effective with glycoprotein IIb/IIIa inhibitor for the treatment of ruptured MCA aneurysms in the acute setting. Prospective, multicenter studies with larger sample sizes are still required to further evaluate the safety and long-term efficacy. |
| first_indexed | 2024-12-19T22:59:37Z |
| format | Article |
| id | doaj.art-2f999568fb3f4befae70fa901c4ea642 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-19T22:59:37Z |
| publishDate | 2021-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-2f999568fb3f4befae70fa901c4ea6422022-12-21T20:02:32ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-01-011110.3389/fneur.2020.631745631745Endovascular Treatment of Ruptured Middle Cerebral Artery Aneurysms With a Low-Profile Visualized Intraluminal Support DeviceGaici Xue0Yu Zhou1Peng Liu2Qiao Zuo3Pengfei Yang4Yibin Fang5Qiang Li6Rui Zhao7Yi Xu8Bo Hong9Qinghai Huang10Jianmin Liu11Department of Neurosurgery, General Hospital of Southern Theatre Command of PLA, Guangzhou, ChinaDepartment of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, ChinaDepartment of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, ChinaDepartment of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, ChinaDepartment of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, ChinaDepartment of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, ChinaDepartment of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, ChinaDepartment of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, ChinaDepartment of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, ChinaDepartment of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, ChinaDepartment of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, ChinaDepartment of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, ChinaObjective: Stenting in ruptured middle cerebral artery (MCA) aneurysms was reported with a high perioperative complication rate. However, the treatment devices and physician's experience have continued to evolve. We performed this retrospective study to evaluate the safety and efficacy of LVIS stent-assisted coiling for ruptured MCA aneurysms.Methods: Patients with acutely ruptured MCA aneurysms treated between November 2014 and October 2019 were retrospectively reviewed. Clinical and angiographic data of those treated with LVIS stents were collected from a prospectively maintained database.Results: A total of 40 patients with 40 ruptured MCA aneurysms were enrolled, which comprised 26.3% (40/152) of all the ruptured MCA aneurysms at the same time. All stents were successfully deployed except for one (2.5%), which had a poor stent opening. Ischemic procedure-related complications were encountered in three patients (7.5%). One patient died of complications related to high-grade SAH on admission. Follow-up (mean 15.9 months) angiography was performed for 36 patients, which showed 33 (91.7%) aneurysms were completely occluded, 1 (2.8%) was improved, 1 (2.8%) was stable, and 1 (2.8%) was recanalized. Clinical follow-up (mean 29.6 months) was available for all survived patients, which showed 38 (95.0%) patients had favorable neurologic outcomes (mRS score 0–2), and 2 (5.0%) patients had poor neurologic outcomes.Conclusion: The use of LVIS stents is feasible, safe, and effective with glycoprotein IIb/IIIa inhibitor for the treatment of ruptured MCA aneurysms in the acute setting. Prospective, multicenter studies with larger sample sizes are still required to further evaluate the safety and long-term efficacy.https://www.frontiersin.org/articles/10.3389/fneur.2020.631745/fullintracranial aneurismmiddle cerebral arterylow-profile visualized intraluminal stentrupturedsafetyvascular disorders |
| spellingShingle | Gaici Xue Yu Zhou Peng Liu Qiao Zuo Pengfei Yang Yibin Fang Qiang Li Rui Zhao Yi Xu Bo Hong Qinghai Huang Jianmin Liu Endovascular Treatment of Ruptured Middle Cerebral Artery Aneurysms With a Low-Profile Visualized Intraluminal Support Device Frontiers in Neurology intracranial aneurism middle cerebral artery low-profile visualized intraluminal stent ruptured safety vascular disorders |
| title | Endovascular Treatment of Ruptured Middle Cerebral Artery Aneurysms With a Low-Profile Visualized Intraluminal Support Device |
| title_full | Endovascular Treatment of Ruptured Middle Cerebral Artery Aneurysms With a Low-Profile Visualized Intraluminal Support Device |
| title_fullStr | Endovascular Treatment of Ruptured Middle Cerebral Artery Aneurysms With a Low-Profile Visualized Intraluminal Support Device |
| title_full_unstemmed | Endovascular Treatment of Ruptured Middle Cerebral Artery Aneurysms With a Low-Profile Visualized Intraluminal Support Device |
| title_short | Endovascular Treatment of Ruptured Middle Cerebral Artery Aneurysms With a Low-Profile Visualized Intraluminal Support Device |
| title_sort | endovascular treatment of ruptured middle cerebral artery aneurysms with a low profile visualized intraluminal support device |
| topic | intracranial aneurism middle cerebral artery low-profile visualized intraluminal stent ruptured safety vascular disorders |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2020.631745/full |
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