Multiple Overlapping Low-Profile Visualized Intraluminal Support Stents for Large Extracranial Carotid Artery...

Area of Science:

• Vascular Surgery
• Interventional Neuroradiology
• Medical Device Technology

Background:

• Extracranial carotid artery aneurysms (ECAAs) are uncommon, with debated optimal treatment strategies.
• Current options like surgical resection and covered stents have limitations.
• Flow diversion shows promise but faces off-label use, reimbursement, and device-specific challenges in ECAAs.

Purpose of the Study:

• To evaluate the feasibility and safety of using multiple overlapping Low-profile Visualized Intraluminal Support (LVIS) stents for reconstructing selected ECAAs.
• To assess parent-artery reconstruction and intra-aneurysmal flow reduction using this technique.

Main Methods:

• Retrospective review of five patients with large ECAAs treated with overlapping LVIS stents.
• Utilized double (3 cases) or triple+ (2 cases) overlapping LVIS stent constructs.
• Primary goal: parent-artery reconstruction and flow reduction via increased metal coverage.

Main Results:

• Mean radiologic follow-up of 24 months.
• Complete occlusion in 2 cases, partial in 3.
• No major thromboembolic or hemorrhagic complications documented.
• Adjunctive/staged treatment required in 3 cases (angioplasty, additional stenting, flow-diverter, stent-graft, coiling).

Conclusions:

• Multiple overlapping LVIS stenting is a feasible and relatively safe reconstructive option for selected large ECAAs.
• This approach is particularly useful when primary flow diversion is restricted.
• Standalone efficacy is limited, especially for large/complex aneurysms, often necessitating adjunctive or staged interventions.