Neuroform, Enterprise, and LVIS Self-Expanding Stents Compared for Treating Cerebral Aneurysms

 

November 21, 2017—A study by Jun Wang, MD, et al compared the clinical and angiographic outcomes of treating cerebral aneurysms with three self-expanding nitinol stents: Neuroform (Stryker), Enterprise (Codman Neuro), and Low-profile Visualized Intraluminal Support stents (LVIS/LVIS Jr; MicroVention Terumo). The data were published online in the Journal of NeuroInterventional Surgery.

As summarized in the Journal of NeuroInterventional Surgery, all three stents proved safe and effective for the treatment of cerebral aneurysms with unfavorable neck, providing suitable support for the coil mass.

Researchers used a procedural database to retrospectively analyze intraprocedure and postprocedure complications and angiographic results for all aneurysm procedures using Neuroform, Enterprise, or LVIS/LVIS Jr stents. To identify predictors of intraprocedure and postprocedure complications, a multivariate logistic regression analysis was completed.

Stent-assisted coiling was used to treat 243 aneurysms (Neuroform group: 109 aneurysms; Enterprise group: 61 aneurysms; LVIS/LVIS Jr: 73 aneurysms) in 229 patients. Results included that the LVIS/LVIS Jr group showed initial complete occlusion in 35 of 73 aneurysms (Raymond–Roy grade scale [RRGS] I 47.9%), the lowest rate among the three stents. On follow-up, the proportion of RRGS I increased for all stent groups but was largest in the LVIS/LVIS Jr group.

Overall, 17 intraprocedural complications were seen in 229 patients (7.4%) and 15 postprocedural complications were found in 198 patients at follow-up (7.6%), with no differences between stent groups. The most common complications we thrombotic events occurring in 13 of 229 (5.7%) patients.

The study investigators advised in the Journal of NeuroInterventional Surgery that all three stents were shown to be safe and effective in the setting studied, and that the LVIS/LVIS Jr stent promoted better progressive aneurysm complete occlusion than the other two stents but seemed to cause more common intraprocedural, stent-related thrombotic events and fewer postprocedural complications.

 

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