Overlapping stents-assisted coiling for vertebral artery dissecting aneurysm: LVIS stent within Neuroform EZ stent

• Published in: Journal of Korean Neurosurgical Society Vol. 65; no. 4; pp. 523 - 530
• Main Authors: Liu, Xing-Long, Wang, Bin, Zhao, Lin-Bo, Jia, Zhen-Yu, Shi, Hai-Bin, Liu, Sheng
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Neurosurgical Society 01.07.2022
• Subjects: Clinical; intracranial aneurysms; overlapping stents; vertebral artery dissecting aneurysms; endovascular treatment
• ISSN: 2005-3711; 1598-7876
• DOI: 10.3340/jkns.2021.0275

To evaluate the safety and efficacy of an overlapped stenting-assisted coiling technique in treating vertebral artery dissecting aneurysm (VADA) via LVIS stent-within-Neuroform EZ stent. From January 2017 to June 2019, 18 consecutive patients with VADAs (ruptured: unruptured = 5: 13) were treated with the overlapping stents assisted-coiling technique in our center. The overlapping manner was a Neuroform EZ stent being deployed first, followed by LVIS stents placement using the 'shelf' technique. The patients' clinical characteristics, technical feasibility and safety, and immediate and follow-up angiographic results were retrospectively reviewed. Seventeen (94.4%) procedures were technically successful with an exact deployment of the stents and patent parent or perforator arteries. The immediate angiographies after procedure confirmed Raymond class I, II, and III occlusion of VADAs were in 12 (66.7%), 2 (11.1%), and 4 cases (22.2%), respectively. Post-procedural complications developed in one patient (5.6%) with minor brainstem infarctions, which resulted from an in-stent thrombosis during the procedure. Angiographic follow-up at 5.7 months (range 3 to 9 months) demonstrated Raymond class I and II occlusion were in all cases (100%). The modified Rankin Scale scores at 21.3 months (range 15 to 42 months) 0-2 in 17 cases (94.4%) and 3 in one case (5.6%). Overlapping stents via LVIS stent-within-Neuroform EZ stent combined with coiling is safe and effective for patients with VADA in the midterm results.