52 Views

Evaluating the Effectiveness of LVIS Stent Treatment for Middle Cerebral Artery Aneurysms: A Meta-Analysis and Systematic Review Approach

Friday, May 3, 2024

Presenting Author(s)

MARCELO Porto Sousa (he/him/his)

Medical Student
Federal University of Rio de Janeiro

Co-Author(s)

SB

Savio Batista, n/a

Medical student
Federal University of Rio de Janeiro, United States
Raphael Bertani, MD

Neurosurgeon
Department of Neurosurgery, University of São Paulo
S�o Paulo, SP, BR
Leonardo de Barros Oliveira (he/him/his)

Medical Student
Department of Neurosurgery, State University of Ponta Grossa, Paraná, Brazil
JS

João Pedro Sanches, n/a

Medical student
Federal University of Rio de Janeiro, United States
MV

Marcos Vinicius do Nascimento da Silva, n/a

Medical student
Federal University of Rio de Janeiro, United States
Marcio Yuri Ferreira, MD

Research Collaborator
Program in Global Surgery and Social Change - Harvard Medical School. Postgraduate Program in Translational Surgery of Federal University of São Paulo, Brazil

Introduction: Middle cerebral artery (MCA) aneurysms are known to have higher complication rates compared to more proximal lesions. The Low-profile Visualized Intraluminal Support (LVIS) has seen increasing use in recent years and has demonstrated superior outcomes in terms of complications and occlusion during follow-up. However, there is a lack of comprehensive evidence systematically evaluating its outcomes.

Methods: Consenting to PRISMA guidelines, we systematically searched studies (January 2000 - October 2023) on Medline, Embase, and Web of Science databases, focusing on those with ≥4 MCA patients treated with LVIS. The studies had to evaluate at least one of the following outcomes: final occlusion, good clinical outcomes, and complications.

Results: From 1043 studies initially found, Nineteen studies, involving 525 patients meeting our inclusion criteria, were comprehensively analyzed using the random effects model. The final occlusion rate was 88% (with 95% CI: 83% to 92%, I²= 42%), and good clinical outcomes were consistently observed overall, with a rate of 100% (95% CI: 99% to 100%, I² = 0%). In the subanalysis of good clinical outcomes, 82 out of 87 patients with ruptured aneurysms showed a rate of 95% (95% CI: 91% to 100%, I²= 0%), and all patients with unruptured aneurysms demonstrated a rate of 100% (95% CI: 99% to 100%, I²= 0%). Low mortality rates were evident, with only one reported death among 444 patients across 18 studies, resulting in a 0% rate (95% CI: 0% to 1%, I² = 0%). Additionally, complications were observed in 44 out of 451 patients, yielding a 7% rate (95% CI: 5% to 10%, I² = 59%).

Conclusion : Our findings demonstrated a significantly high final occlusion rate and good clinical outcomes. Additionally, the low mortality rate observed emphasizes the potential advantages of LVIS in endovascular procedures. Thus, LVIS demonstrates efficacy and safety in the treatment of MCA aneurysms.