Safety and effectiveness of the LVIS and LVIS Jr devices for the treatment of intracranial aneurysms: Final results of the LEPI multicenter cohort study.

Aneurysm Device Intervention Stent

Journal

Journal of neuroradiology = Journal de neuroradiologie
ISSN: 0150-9861
Titre abrégé: J Neuroradiol
Pays: France
ID NLM: 7705086

Informations de publication

Date de publication:
17 Oct 2023
Historique:
received: 12 07 2023
revised: 16 10 2023
accepted: 16 10 2023
pubmed: 20 10 2023
medline: 20 10 2023
entrez: 20 10 2023
Statut: aheadofprint

Résumé

The Low profile visualized intraluminal support (LVIS)/LVIS Jr is a self-expanding braiding stent for the treatment of intracranial aneurysm. This study is to determine the safety and effectiveness of the LVIS/LVIS Jr for the treatment of intracranial aneurysms in a real-world setting. This prospective, observational, multicenter study enrolled patients with unruptured, ruptured and recanalized intracranial aneurysms treated with the LVIS stents, between February 2018 to December 2019. Primary endpoint was the cumulative morbidity and mortality rate (CMMR) assessed at 12 months follow-up (FU). A total of 130 patients were included (62.3 % women, mean age 55.9 ± 11.4) on an intention-to-treat basis. Four patients (3.1 %) had 2 target aneurysms; 134 total aneurysms were treated. The aneurysms were mainly located on the middle cerebral artery (41/134; 30.6 %) and the anterior communicating artery (31/134; 23.1 %). The CMMR at 1 year linked to the procedure and/or device was 4.6 % (6/130). The overall mortality was 1.5 % (2/130), none of these deaths adjudged as being linked to the procedure and/or device. All aneurysms (134/134, 100 %) were successfully treated with LVIS stent and/or other devices. At a mean FU of 16.8 months post-procedure, complete/nearly complete occlusion was achieved in 112 aneurysms (92.6 %), and only 3 patients (2.5 %) required aneurysm retreatment. This study provides evidence that the LVIS/LVIS Jr devices are safe and effective in the treatment of complex intracranial aneurysms, with very high rates of adequate occlusion at FU. These angiographic results are stable over time with an acceptable complication rate. ClinicalTrial.gov under NCT03553771.

Sections du résumé

BACKGROUND BACKGROUND
The Low profile visualized intraluminal support (LVIS)/LVIS Jr is a self-expanding braiding stent for the treatment of intracranial aneurysm. This study is to determine the safety and effectiveness of the LVIS/LVIS Jr for the treatment of intracranial aneurysms in a real-world setting.
METHODS METHODS
This prospective, observational, multicenter study enrolled patients with unruptured, ruptured and recanalized intracranial aneurysms treated with the LVIS stents, between February 2018 to December 2019. Primary endpoint was the cumulative morbidity and mortality rate (CMMR) assessed at 12 months follow-up (FU).
RESULTS RESULTS
A total of 130 patients were included (62.3 % women, mean age 55.9 ± 11.4) on an intention-to-treat basis. Four patients (3.1 %) had 2 target aneurysms; 134 total aneurysms were treated. The aneurysms were mainly located on the middle cerebral artery (41/134; 30.6 %) and the anterior communicating artery (31/134; 23.1 %). The CMMR at 1 year linked to the procedure and/or device was 4.6 % (6/130). The overall mortality was 1.5 % (2/130), none of these deaths adjudged as being linked to the procedure and/or device. All aneurysms (134/134, 100 %) were successfully treated with LVIS stent and/or other devices. At a mean FU of 16.8 months post-procedure, complete/nearly complete occlusion was achieved in 112 aneurysms (92.6 %), and only 3 patients (2.5 %) required aneurysm retreatment.
CONCLUSION CONCLUSIONS
This study provides evidence that the LVIS/LVIS Jr devices are safe and effective in the treatment of complex intracranial aneurysms, with very high rates of adequate occlusion at FU. These angiographic results are stable over time with an acceptable complication rate.
TRIAL REGISTRATION BACKGROUND
ClinicalTrial.gov under NCT03553771.

Identifiants

pubmed: 37858720
pii: S0150-9861(23)00253-5
doi: 10.1016/j.neurad.2023.10.007
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT03553771']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier Masson SAS.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest MP reports support for attending meetings and/or travel from Balt, and stock or stock options (Basecamp Vascular, Synchron, Radical Catheter, Vastrax, Intradys). LP reports consulting fees from Balt, Microvention, Phenox. FC reports consulting fees from Balt, Medtronic, Microvention, Stryker, stock or stock options (Collavidance, Intradys), and leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid (Artedrone). PM reports consulting fees from Medtronic, Stryker, Artiria, payment to his institution (Codman), and served as chairman of the adverse events monitoring committee for this study, sponsored by Microvention. GM reports consulting fees from Microvention, Balt, Stryker, honoraria for lectures (Medtronic, Johnson & Jonhson). AR reports consulting fees from Balt. The other authors report no conflicts.

Auteurs

Géraud Forestier (G)

Neuroradiology Department, University Hospital of Limoges, Dupuytren, Limoges, France. Electronic address: geraudforestier@gmail.com.

Michel Piotin (M)

Department of Interventional Neuroradiology, FHU NeuroVasc, Adolphe de Rothschild Foundation Hospital, Paris, France; Laboratory for Vascular Translational Science UMRS 1148, INSERM, Paris, France.

Yves Chau (Y)

Department of Neuro-Interventional and Vascular Interventional, University Hospital of Nice, Nice, France.

Anne-Laure Derelle (AL)

Department of Diagnostic and Therapeutic Neuroradiology, CHRU-Nancy, Université de Lorraine, Nancy, France.

Hervé Brunel (H)

Department of Neuroradiology, APHM, Marseille, France.

Mohammed Aggour (M)

Department of Neuroradiology, University Hospital of Saint-Étienne, Saint-Étienne, France.

Suzana Saleme (S)

Neuroradiology Department, University Hospital of Limoges, Dupuytren, Limoges, France.

Olivier Levrier (O)

Department of Interventional Neuroradiology, Polyclinique Clairval, Marseille, France.

Laurent Pierot (L)

Department of Interventional Neuroradiology, University Hospital of Reims, Reims, France.

Xavier Barreau (X)

Department of Interventional Neuroradiology, Pellegrin Hospital, University Hospital of Bordeaux, Bordeaux, France.

Kamel Boubagra (K)

Department of Interventional Neuroradiology, University Hospital of Grenoble, Grenoble, France.

Kévin Janot (K)

Department of Diagnostic and Interventional Neuroradiology, Tours University Hospital, Tours, France.

Charlotte Barbier (C)

Department of Diagnostic and Interventional Neuroradiology, University Hospital of Caen, Caen, France.

Frédéric Clarençon (F)

Department of Interventional Neuroradiology, Sorbonne University, AP-HP, Pitié Salpêtrière - Charles Foix Hospital, Paris, France; GRC BioFast, Sorbonne University, Paris VI, France.

Emmanuel Chabert (E)

Department of Diagnostic and Interventional Neuroradiology, University Hospital of Clermont-Ferrrand, Clermont-Ferrand, France.

Laurent Spelle (L)

NEURI Brain Vascular Center, Interventional Neuroradiology, Bicetre University-Hospital, Le Kremlin-Bicetre, France.

Charles Arteaga (C)

Radiology Department, Sainte-Anne Hospital, Toulon, France.

Arturo Consoli (A)

Interventional and Diagnostic Neuroradiology, Foch Hospital, University of Versailles Saint-Quentin-des-Yvelines, France.

Paolo Machi (P)

Diagnostic and Interventional Neuroradiology department, Geneva University Hospitals, Geneva, Switzerland.

Raphaël Blanc (R)

Department of Interventional Neuroradiology, FHU NeuroVasc, Adolphe de Rothschild Foundation Hospital, Paris, France; Laboratory for Vascular Translational Science UMRS 1148, INSERM, Paris, France.

Georges Rodesch (G)

Interventional and Diagnostic Neuroradiology, Foch Hospital, University of Versailles Saint-Quentin-des-Yvelines, France.

Jonathan Cortese (J)

NEURI Brain Vascular Center, Interventional Neuroradiology, Bicetre University-Hospital, Le Kremlin-Bicetre, France; Faculty of Medicine, Paris-Saclay University, INSERM U1195, Le Kremlin-Bicetre, France.

Nader Sourour (N)

Department of Interventional Neuroradiology, Sorbonne University, AP-HP, Pitié Salpêtrière - Charles Foix Hospital, Paris, France.

Denis Herbreteau (D)

Department of Diagnostic and Interventional Neuroradiology, Tours University Hospital, Tours, France.

Olivier Heck (O)

Department of Interventional Neuroradiology, University Hospital of Grenoble, Grenoble, France.

Sébastien Soize (S)

Department of Interventional Neuroradiology, University Hospital of Reims, Reims, France.

Gaultier Marnat (G)

Department of Interventional Neuroradiology, Pellegrin Hospital, University Hospital of Bordeaux, Bordeaux, France.

Aymeric Rouchaud (A)

Neuroradiology Department, University Hospital of Limoges, Dupuytren, Limoges, France; CNRS, XLIM, UMR 7252, Limoges 87000, France.

René Anxionnat (R)

Department of Diagnostic and Therapeutic Neuroradiology, CHRU-Nancy, Université de Lorraine, Nancy, France.

Jacques Sedat (J)

Department of Neuro-Interventional and Vascular Interventional, University Hospital of Nice, Nice, France.

Charbel Mounayer (C)

Neuroradiology Department, University Hospital of Limoges, Dupuytren, Limoges, France; CNRS, XLIM, UMR 7252, Limoges 87000, France.

Classifications MeSH