AJNR. American journal of neuroradiology · 2026
High-Resolution Micro-DynaCT Assessment and Mid-Term Clinical Outcomes of the LVIS EVO Stent for Wide-Neck Intracranial Aneurysms: Safety and Efficacy from a Large U.S. Single-Center Experience.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Almasri Sami, Kim Jaeha, Gandhi Om H, Snyder Sarah J, Tierradentro-García Luis O, Anandarajah Aaron A, Yu Nathan, Dumasia Suraj R, Feroze Abdullah, Bagley Linda, Choudhri Omar
Аннотация
BACKGROUND AND PURPOSE: The Low-profile Visualized Intraluminal Support EVO (LVIS EVO) is a next-generation braided stent designed for wide-neck intracranial aneurysm treatment. It offers complete fluoroscopic visibility, enhanced flow diversion-like effects, high metal coverage, and compatibility with 0.017-inch microcatheters for distal access. This study evaluated real-world safety and efficacy of LVIS EVO in a large, consecutive single-center cohort with high-resolution micro-DynaCT assessment and mid-term follow-up.
MATERIALS AND METHODS: We retrospectively reviewed 53 consecutive patients treated with LVIS EVO between January 2024 and February 2025. Over 90% of cases were performed by a single surgeon using predominantly radial arterial access. The device was deployed across three strategies: with coils (jailed microcatheter technique), with WEB intrasaccular devices, or as standalone flow diversion. Patient demographics, aneurysm characteristics, and procedural details were recorded. Stent apposition and metal coverage at the neck were assessed in all cases using micro-DynaCT. Occlusion status and complications were assessed immediately and at 3- to 6-month follow-up using catheter-based angiography.
RESULTS: Median patient age was 69 years (IQR, 61-75), with 41 patients (77.4%) being female. Aneurysms were most often located in the anterior communicating artery (20, 37.7%), basilar artery (16, 30.2%), and middle cerebral artery bifurcation (8, 15.1%). Periprocedural thrombotic complications occurred in 3 patients (5.6%), all successfully managed with intra-arterial tirofiban without permanent neurological deficits. No delayed complications occurred at mid-term follow-up. Among 38 patients with available follow-up, 35 achieved adequate occlusion (Grade 1-2 RROC: 92.1%), with incomplete stent apposition noted on micro-DynaCT in 2 patients.
CONCLUSION: LVIS EVO demonstrated favorable safety and efficacy for treating intracranial aneurysms across three deployment strategies, with minimal complications and high occlusion rates at mid-term follow-up. Complete micro-DynaCT visibility in all cases enabled reliable documentation of stent behavior, metal coverage at the neck, and wall apposition, providing intraprocedural feedback not achievable with other stent platforms.
MATERIALS AND METHODS: We retrospectively reviewed 53 consecutive patients treated with LVIS EVO between January 2024 and February 2025. Over 90% of cases were performed by a single surgeon using predominantly radial arterial access. The device was deployed across three strategies: with coils (jailed microcatheter technique), with WEB intrasaccular devices, or as standalone flow diversion. Patient demographics, aneurysm characteristics, and procedural details were recorded. Stent apposition and metal coverage at the neck were assessed in all cases using micro-DynaCT. Occlusion status and complications were assessed immediately and at 3- to 6-month follow-up using catheter-based angiography.
RESULTS: Median patient age was 69 years (IQR, 61-75), with 41 patients (77.4%) being female. Aneurysms were most often located in the anterior communicating artery (20, 37.7%), basilar artery (16, 30.2%), and middle cerebral artery bifurcation (8, 15.1%). Periprocedural thrombotic complications occurred in 3 patients (5.6%), all successfully managed with intra-arterial tirofiban without permanent neurological deficits. No delayed complications occurred at mid-term follow-up. Among 38 patients with available follow-up, 35 achieved adequate occlusion (Grade 1-2 RROC: 92.1%), with incomplete stent apposition noted on micro-DynaCT in 2 patients.
CONCLUSION: LVIS EVO demonstrated favorable safety and efficacy for treating intracranial aneurysms across three deployment strategies, with minimal complications and high occlusion rates at mid-term follow-up. Complete micro-DynaCT visibility in all cases enabled reliable documentation of stent behavior, metal coverage at the neck, and wall apposition, providing intraprocedural feedback not achievable with other stent platforms.