The ELVIS study: Medium and long-term Efficacy of LVIS EVO stent-assisted coil embolisation for unruptured saccular intracranial aneurysms-A tertiary single-centre experience.

Introduction: The LVIS EVO (MicroVention^®) is a braided stent designed to assist coil embolisation of intracranial aneurysms. It offers several structural innovations over previous and currently available braided, and laser-cut, stents that are theorised to improve procedural success. This retrospective audit aims to determine the success and complication rates of LVIS EVO-assisted coil embolisation in unruptured saccular aneurysms at a tertiary neurovascular referral centre in Queensland, Australia.

Methods: The medical records of all patients who underwent elective LVIS EVO-assisted coil embolisation at our institution between 2020 and 2024 were reviewed. Clinical and radiologic outcomes, including occlusion rate, occlusion grade (modified Raymond Roy classification-MRRC), complications, recurrence rate, and change in modified Rankin scale (mRS) were recorded, alongside aneurysm characteristics and technical procedural details.

Results: Of 29 cases, 2 were excluded due to complex aneurysms requiring off-label LVIS EVO use. Twenty-seven (27) saccular aneurysms in 26 patients (18 female; 8 male) were included. Most (22/27) involved the anterior cerebral artery (ACA), primarily the anterior communicating artery (18/27). Complete occlusion was seen in 55.6% (15/27) of cases immediately post-procedure, in 85.2% (23/27) at 3 months, and in 84.2% (16/19) at a median of 12-months post-procedure. A recurrence was seen in 7.4% (2/27) of patients. No procedural or long-term complications, and no significant changes in 90-day mRS, were noted.

Conclusion: Our results show 100% technical success reflecting existing literature and contribute further by providing data on medium to long-term success rates with LVIS EVO-assisted coil embolisation for unruptured saccular aneurysms.