Y-configuration stenting for coiling of wide-neck bifurcation aneurysms using Low-profile Visualized Intraluminal Support Junior.

BACKGROUND: Little has been reported about the feasibility and durability of a Low-profile Visualized Intraluminal Support Junior (LVIS Jr) Y-stenting device for wide-neck bifurcation aneurysms.
PURPOSE: To evaluate the feasibility and durability of LVIS Jr Y-stenting for coiling of unruptured wide-neck bifurcation aneurysms.
METHODS: We identified patients in whom LVIS Jr Y-stenting was attempted for unruptured wide-neck bifurcation aneurysms from a prospectively maintained registry of a referral hospital. Procedural success rate, treatment-related morbidity, and clinical and angiographic outcomes were retrospectively assessed.
RESULTS: LVIS Jr Y-stenting was attempted for a total of 21 aneurysms in 21 patients (mean age 60±8.9 years; M:F=6:15): nine basilar artery, six anterior communicating artery, four middle cerebral artery, one internal carotid artery, and one vertebrobasilar fenestration aneurysms. The mean dome and neck size were 7.9±2.7 mm and 5.7±1.8 mm, respectively. All attempts were successful. Treatment-related morbidity occurred in one individual with a modified Rankin Scale (mRS) score of 2. Immediate postprocedural angiograms showed complete occlusion in 15 (71.4%) and neck remnant in 6 (28.6%) patients. All 21 patients had good outcomes (mRS score 0-2) for a mean of 12 months' follow-up (range 6-27 months); mRS score 0 in 20 patients and mRS score 2 in one patient, respectively. Follow-up imaging over a mean of 11 months (range 6-18 months) was available in 18 patients (85.7%). All aneurysms showed complete occlusion at follow-up.
CONCLUSIONS: LVIS Jr Y-stenting and coiling for wide-neck bifurcation aneurysms seems to be feasible with acceptable safety and to provide durable aneurysm occlusion for wide-neck bifurcation aneurysms. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.