Turkish Neurosurgery
Efficacy and Safety Assessment of LVIS JR Device in Treating Wide-Neck Aneurysms A Comprehensive Systematic Review and Single-Arm Meta-Analysis |
Marcelo Porto Sousa1, Guilherme Nunes Marques1, Livia Viviani de Abreu1, Filipi Fim Andreão1, Leonardo de Barros Oliveira2, Gabriel Verly1, Sávio Batista1, Guilherme Melo Silva1, Raphael Muszkat Besborodco3, Raphael Bertani4 |
1University Federal of Rio de Janeiro, Faculty of Medicine, Rio de Janeiro - Rio de Janeiro, 2State University of Ponta Grossa, Faculty of Medicine, Ponta Grossa - Paraná, 3NYU Langone Health, Rusk Rehabilitation, New York - New York, 4University of São Paulo, Department of Neurosurgery, São Paulo - São Paulo, |
DOI: 10.5137/1019-5149.JTN.46167-23.2 |
Introduction: Wide-neck aneurysms pose a daunting challenge to endovascular neurosurgeons. Thus, the Low-profile Visualized Intraluminal Support Junior (LVIS Jr) stent from MicroVention-Terumo has emerged as a promising treatment option. This meta-analysis aims to evaluate the usability and effectiveness of this technology in managing wide-neck aneurysms.
Methods: We systematically searched in PubMed, Embase, and Web of Science databases, comprising studies with outcomes related to LVIS Jr use in wide-neck aneurysms. Data was extracted from the selected articles and subjected to statistical analysis. Additionally, the ROBINS-I tool was employed for quality assessment.
Results: Among 886 initially identified articles, 20 studies met our inclusion criteria, comprising a total of 557 patients. Our analysis revealed a 96% final occlusion rate under common effects and 93% under random effects, with substantial heterogeneity (I² = 69%), and good clinical outcomes were observed in 99% of cases with low heterogeneity (I² = 27%). Mortality rates were extremely low, with only one reported death out of 499 patients across 18 studies, resulting in a 0% mortality rate for common and random effects, and no heterogeneity (I² = 0). Complications occurred in 44 of 482 patients, yielding a 6% rate in the common effect model and 6% in the random effects model, with nonsignificant heterogeneity (I² = 25%).
Conclusion: A favorable rate of final occlusion and good clinical outcomes was observed with LVIS Jr. Moreover, the low mortality and complication rates highlight its safety.
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Corresponding author : Marcelo Porto Sousa