The low-profile visualized intraluminal support junior (LVIS Jr.) is a new generation low-profile braided stent. Our aim was to evaluate the safety and efficacy of the LVIS Jr. in the stent-assisted coiling of unruptured middle cerebral artery (MCA) aneurysms. This was a multicenter retrospective study. Patient demographics, aneurysm characteristics, procedural details, complications, and the results of clinical and imaging follow-up were analyzed. Four centers participated in the study. A total of 162 consecutive patients with 162 unruptured MCA aneurysms were included for the analysis. The mean aneurysm size was 7.6 mm (range 2 to 37 mm) and 97.5% were wide-necked. Immediate postprocedural angiograms showed Raymond-Roy class 1 in 118 (72.8%), class 2 in 23 (14.2%), and class 3 in 21 patients (13%). Periprocedural complications occurred in 14 patients (8.6%). There were no procedure-related deaths. Follow-up imaging at 12-18 months post-procedure showed Raymond-Roy class 1 in 132 (81.5%), class 2 in 17 (10.5%), and class 3 in 13 patients (8%). There were 3 cases of in-stent stenosis (1.9%). All 162 patients had good clinical outcome (mRS score 0-2) at 90 days post-procedure. Stent-assisted coiling of unruptured MCA aneurysms with the LVIS Jr. stent is safe and effective, with high immediate and long-term total occlusion rates.
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http://dx.doi.org/10.3390/jcm9103168 | DOI Listing |
J Neuroradiol
January 2025
Departments of Neuroradiology, HCL, Lyon, France.
Objective: Flow diversion is increasingly used as an endovascular treatment for intracranial aneurysms. FRED-EPI is a prospective, multicenter, French study, conducted to analyze the safety and efficacy of aneurysm treatment with FRED/FRED Jr (Microvention, AlisoViejo, CA, USA) in current clinical practice.
Patients And Methods: Patients with intracranial aneurysms treated with FRED and FRED Jr who agreed to participate were prospectively and consecutively included in all French centers using these devices.
Sci Rep
January 2025
Department of Neurosurgery, Kepler University Hospital and Johannes Kepler University Linz, Wagner-Jauregg Weg 15, 4020 Linz and Altenbergerstrasse 69, Linz, 4040, Austria.
Accurate rupture risk assessment is essential for optimizing treatment decisions in patients with cerebral aneurysms. While computational fluid dynamics (CFD) has provided critical insights into aneurysmal hemodynamics, most analyses focus on blood flow patterns, neglecting the biomechanical properties of the aneurysm wall. To address this limitation, we applied Fluid-Structure Interaction (FSI) analysis, an integrative approach that simulates the dynamic interplay between hemodynamics and wall mechanics, offering a more comprehensive risk assessment.
View Article and Find Full Text PDFJ Clin Med
January 2025
Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
The management of multiple intracranial aneurysms presents significant clinical challenges, particularly when complicated by underlying conditions such as cerebral atherosclerosis. This case report highlights the successful treatment of a 66-year-old female diagnosed with three intracranial aneurysms located in the right middle cerebral artery (MCA), pericallosal artery, and M2 segment. The patient also had a history of systemic atherosclerosis and right-sided breast cancer, factors that increased the complexity of surgical intervention.
View Article and Find Full Text PDFNeurosurg Rev
January 2025
Department of Neurosurgery, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, 15355, Ansan, Gyeonggi-do, South Korea.
Although many institutions increasingly perform endovascular coiling instead of microsurgical clipping as the primary treatment for ruptured aneurysms, there remains ongoing debate regarding the optimal treatment strategy for ruptured middle cerebral artery (MCA) aneurysms. Therefore, we compared the outcomes of clipping and coiling for treating ruptured MCA aneurysms. A total of 155 ruptured MCA aneurysms that were deemed eligible for both clipping and coiling were retrospectively reviewed.
View Article and Find Full Text PDFActa Neurochir (Wien)
January 2025
Department of Neurosurgery, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
Background: The Focused Sylvian Approach (FSA) is a refined, minimally invasive technique for clipping small to medium-sized middle cerebral artery (MCA) aneurysms, prioritizing safety and aesthetics.
Method: The craniotomy remains confined to the superior temporal line, with the incision concealed within the temporal muscle. The Sylvian fissure is carefully dissected to preserve venous structures.
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