Comparison of LVIS and Enterprise stent-assisted coiling embolization for ruptured intracranial aneurysms: a propensity score-matched cohort study

• Published in: Neurosurgical review 2024-09, Vol.47 (1), p.560, Article 560
• Main Authors: Shu, Lei, Xiao, Bing, Jiang, Yuan, Tang, Shiliang, Yan, Tengfeng, Wu, Yanze, Wu, Miaojing, Lv, Shigang, Lai, Xianliang, Zhu, Xingen, Hu, Ping, Ye, Minhua
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aneurysm, Ruptured - therapy; Cohort Studies; Embolization, Therapeutic - instrumentation; Embolization, Therapeutic - methods; Endovascular Procedures - methods; Female; Humans; Intracranial Aneurysm - therapy; Male; Medicine; Medicine & Public Health; Middle Aged; Neurosurgery; Propensity Score; Stents; Subarachnoid Hemorrhage - therapy; Treatment Outcome
• ISSN: 1437-2320; 1437-2320
• DOI: 10.1007/s10143-024-02756-8

The role of a low-profile visualized intraluminal support stent (LVIS) and Enterprise in the treatment of unruptured intracranial aneurysms is well established. Although previous studies have investigated one single type of stent for the treatment of ruptured intracranial aneurysms (RIA), the safety and efficacy between the two types of stents has not been fully explored. Herein we conducted a study to compare the outcomes of the two stents for treatment of RIA. This is a prospective registry database of aneurysmal subarachnoid hemorrhage (aSAH) patients admitted to a single institution between 2018 and 2021. We collected patient baseline information, secondary complications, follow-up angiographic data, long-term prognostic outcomes, and conducted propensity score matching (PSM) analysis with 1:1 ratio and a multivariable logistic regression to compare the outcomes of the two types of stents. A total of 231 patients with RIAs were included in this study, with 108 treated using the LVIS device and 123 treated using the Enterprise device. Before PSM analysis, only the incidence of poor prognosis after 12 months was higher in the Enterprise group comparing to the LVIS group (20% vs. 10%, P = 0.049). After PSM analysis, there was a higher occurrence of delayed cerebral ischemia (DCI) in the Enterprise group compared to the LVIS group (odds ratio [OR] 3.95, 95% confidence interval [CI] [1.20–13.01], P = 0.024). However, no significant difference in prognosis was observed after PSM adjustment. Furthermore, subgroup analysis revealed that patients with female (P = 0.019), hypertension (P = 0.048), and anterior circulation aneurysms (P = 0.019) receiving the Enterprise device had a higher risk of DCI. The overall efficacy of LVIS and Enterprise in the treatment of RIA is comparable, while the incidence of DCI in the LVIS group is lower than that in the Enterprise group after PSM analysis. Registration number: NCT05738083 ( https://clinicaltrials.gov/ ).