Introduction: This report details our experience with the Low-profile Visualized Intraluminal Support Junior (LVIS Jr.) device (MicroVention-Terumo, Inc., Tustin, CA), with an emphasis on evolving treatment strategies, feasibility, complication rates and outcomes
Methods: We retrospectively reviewed records of patients treated with the LVIS Jr. device for intracranial aneurysms in Medellin, Colombia
Results: 254 patients with 279 aneurysms underwent aneurysm treatment with LVIS Jr during a 36-month study period. Stent deployment was successful in 100% of cases. 224 aneurysms were treated with stent-assisted coil embolization resulting in immediate complete occlusion in 90% of cases. 55 lesions were treated with stent-alone approach: 21 dissecting, blood blister-like aneurysms treated without coils, and 34 small aneurysms which treatment was planned in stages with further coiling after endothelization. Imaging follow-up was available for 104 aneurysms. None major recanalization for retreatment was observed. Seventeen patients presented with immediate thrombo-embolic complications (6.6%) and IIb-IIIa GPI administration was necessary. Eight of these strokes were associated with transient deficits, yielding a stroke rate of 3.1%. Six patients died (2.4%) due to clinical conditions, not as direct consequence of stenting. No significant in-stent stenosis, migration, delayed hemorrhage, or permanent deficits were observed. Of those patients with follow-up, a good functional outcome based on the modified Rankin Scale score (mRS = 2) was achieved in 100% of cases
Conclusions: LVIS Jr. facilitates the endovascular treatment of complex and wide necked cerebral aneurysms especially for aneurysms involving distal and small vessels. Results are promising in a variety of situations with safety and low rates of complications. Patients with acute SAH due to dissecting or wide-neck ruptured aneurysms can be treated under special considerations.
Patient Care: Mid-term FU shows Safety, Feasibility, Effectivity
Learning Objectives: Improving LVISjr indications