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Flow Diversion via LVIS Blue Stent within Enterprise Stent in Patients with Vertebral Artery Dissecting Aneurysm.

 Yong Cheol Lim  ;  Yong Sam Shin  ;  Joonho Chung 
 World Neurosurgery, Vol.117 : 203-207, 2018 
Journal Title
 World Neurosurgery 
Issue Date
Blood Vessel Prosthesis ; Catheters ; Endovascular Procedures/instrumentation* ; Endovascular Procedures/methods ; Equipment Design ; Female ; Humans ; Middle Aged ; Neurosurgical Procedures/instrumentation ; Neurosurgical Procedures/methods ; Stents* ; Vertebral Artery/diagnostic imaging ; Vertebral Artery/surgery* ; Vertebral Artery Dissection/diagnostic imaging ; Vertebral Artery Dissection/surgery*
Dissecting aneurysm ; Enterprise ; Flow diverters ; LVIS Blue ; Vertebral artery dissection
A new Low-profile Visualized Intraluminal Support device (LVIS Blue) is a braided stent that provides a higher degree of metal coverage. This stent may be beneficial for complete obliteration of an aneurysm due to not only its support of a higher occlusion rate using coils inside of the aneurysm but also its flow-diverting effect. We introduce and describe a new flow-diversion technique using an LVIS Blue stent within an Enterprise stent for patients with vertebral artery (VA) dissecting aneurysms. A 6-Fr guiding catheter was positioned in the ipsilateral VA. A microcatheter with an inner diameter of 0.021 inches was navigated and positioned across the dissecting segment of the VA. An Enterprise stent was then deployed and used to cover the dissecting segment by pushing the pusher wire of the stent while simultaneously unsheathing the microcatheter. The microcatheter was navigated along the remaining pusher wire to the distal VA through the Enterprise stent. An LVIS Blue stent was introduced and positioned such that it overlapped the previous stent in order to divert blood flow away from the dissecting segment. We present a case in which this technique was used to successfully obliterate a dissecting aneurysm while maintaining the VA patency with vessel wall remodeling. The LVIS Blue stent-within-an-Enterprise stent technique may be an effective treatment option for patients with VA dissecting aneurysms as an alternative technique to flow diverters.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Chung, Joon Ho(정준호)
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