Safety and Efficacy of the LVIS EVO Device for Stent-Assisted Coiling of Intracranial Aneurysms: A Systematic Review and Meta-Analysis

Background: The low-profile visualized intraluminal support EVO (LVIS EVO) stent is a novel device for stent-assisted coiling (SAC) that offers improved visibility, radial force, and navigability in tortuous cerebral vessels. This systematic review and meta-analysis evaluated the safety and efficacy of the LVIS EVO stent in treating intracranial aneurysms (IAs). Methods: A systematic search of PubMed, Web of Science, Cochrane Library, and Scopus databases to identify studies reporting clinical outcomes of LVIS EVO in SAC of IAs was performed. Primary outcomes included aneurysm occlusion based on the Raymond-Roy Occlusion Classification (RROC), procedural, and clinical complication rates. Pooled estimates with 95% confidence intervals (CIs) were calculated using either a fixed- or random-effects model. Heterogeneity was assessed using the I² statistic. Sensitivity analyses were conducted using the leave-one-out method. Results: Twelve studies involving 567 patients and 586 aneurysms were included. Immediate angiographic results showed complete occlusion (RROC I) in 78% (95% CI: 0.53-0.92), residual neck (RROC II) in 13% (95% CI: 0.08-0.21), and residual aneurysm (RROC III) in 9% (95% CI: 0.02-0.34). At follow-up, complete obliteration was observed in 73% (95% CI: 0.60-0.83). Procedural complications occurred in 5% (95% CI: 0.03-0.09), and clinical complications in 6% (95% CI: 0.04-0.10). Conclusions: The LVIS EVO stent demonstrated high technical success, effective aneurysm occlusion, and low complication rates, supporting its safety and efficacy. Prospective studies are warranted to confirm long-term outcomes.