Deployment techniques and crossability of the EVO stent in wide-neck bifurcation aneurysms: An in vitro evaluation

Affiliations

Brain and Spine Institute, Lutheran General Hospital

Abstract

Background: Stent-assisted coiling (SAC) is a well-established technique for treating wide-neck and bifurcation intracranial aneurysms. The second-generation Low-Profile Visualized Intraluminal Support (LVIS) EVO stent offers improved fluoroscopic visibility and deployment control; however, bench data on its performance in complex configurations remains limited.Objective: To evaluate the deployment and crossability of the LVIS EVO stent using shouldering and Y-stenting (crossing and parallel) techniques in a flow model, given their complexity and clinical relevance in the treatment of wide-neck bifurcation aneurysms. Methods: Two silicone basilar tip aneurysm replicas were used in a flow model under physiological conditions. LVIS EVO stents were deployed using the three techniques. A 0.014-inch microwire and 0.017-inch microcatheter were used to assess crossability through inner and outer vessel curvatures. Outcomes included device tracking under fluoroscopy, deployment success, and crossability profile. Results: All stent deployments were technically successful with accurate positioning, excellent fluoroscopic visibility, and no evidence of migration, prolapse, or deformation. Crossability testing confirmed that a 0.017-inch microcatheter and 0.014-inch microwire could be advanced smoothly through both the stent lumen and across the stent walls in all configurations without the need for additional maneuvers. Conclusion: The LVIS EVO stent demonstrated reliable deployment and crossability across complex bifurcation configurations in a flow model. Its radiopacity and flexible design support its use in advanced SAC techniques.

Document Type

Article

PubMed ID

40767043

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