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Research ArticleExpedited Publication
Open Access

WEB-DL Endovascular Treatment of Wide-Neck Bifurcation Aneurysms: Short- and Midterm Results in a European Study

B. Lubicz, J. Klisch, J.-Y. Gauvrit, I. Szikora, M. Leonardi, T. Liebig, N.P. Nuzzi, E. Boccardi, F.D. Paola, M. Holtmannspötter, W. Weber, E. Calgliari, V. Sychra, B. Mine and L. Pierot
American Journal of Neuroradiology March 2014, 35 (3) 432-438; DOI: https://doi.org/10.3174/ajnr.A3869
B. Lubicz
aFrom the Department of Neuroradiology (B.L., B.M.), Erasme University Hospital, Brussels, Belgium
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J. Klisch
bDepartment of Diagnostic and Interventional Radiology and Neuroradiology (J.K., V.S.), Helios General Hospital, Erfurt, Germany
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J.-Y. Gauvrit
cDepartment of Neuroradiology (J.-Y.G.), Centre Hospitalier Universitaire Rennes, Rennes, France
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I. Szikora
dDepartment of Neuroradiology (I.S.), National Institute of Neurosciences, Budapest, Hungary
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M. Leonardi
eDepartment of Neuroradiology (M.L.), Ospedale Bellaria, Bologna University, Bologna, Italy
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T. Liebig
fDepartment of Neuroradiology (T.L.), Universitaetsklinikum Koeln, Cologne, Germany
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N.P. Nuzzi
gDepartment of Neuroradiology (N.P.N.), Ospedale Galliera, Genova, Italy
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E. Boccardi
hDepartment of Neuroradiology (E.B.), Ospedale Niguarda, Milano, Italy
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F.D. Paola
iDepartment of Neuroradiology (F.D.P.), Ospedale Santa Maria, Treviso, Italy
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M. Holtmannspötter
jDepartment of Neuroradiology (M.H.), Rigshospitalet, Copenhagen, Denmark
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W. Weber
kDepartment of Neuroradiology (W.W.), Knappschaftskrankenhaus, Recklinghausen, Germany
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E. Calgliari
lDepartment of Neuroradiology (E.C.), Ospedale dell'Angelo, Mestre, Italy
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V. Sychra
bDepartment of Diagnostic and Interventional Radiology and Neuroradiology (J.K., V.S.), Helios General Hospital, Erfurt, Germany
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B. Mine
aFrom the Department of Neuroradiology (B.L., B.M.), Erasme University Hospital, Brussels, Belgium
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L. Pierot
mDepartment of Neuroradiology (L.P.), Hôpital Maison-Blanche, Université Reims-Champagne-Ardenne, Reims, France.
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Abstract

BACKGROUND AND PURPOSE: Flow disruption with the WEB-DL device has been used safely for the treatment of wide-neck bifurcation aneurysms, but the stability of aneurysm occlusion after this treatment is unknown. This retrospective multicenter European study analyzed short- and midterm data in patients treated with WEB-DL.

MATERIALS AND METHODS: Twelve European neurointerventional centers participated in the study. Clinical data and pre- and postoperative short- and midterm images were collected. An experienced interventional neuroradiologist independently analyzed the images. Aneurysm occlusion was classified into 4 grades: complete occlusion, opacification of the proximal recess of the device, neck remnant, and aneurysm remnant.

RESULTS: Forty-five patients (34 women and 11 men) 35–74 years of age (mean, 56.3 ± 9.6 years) with 45 aneurysms treated with the WEB device were included. Aneurysm locations were the middle cerebral artery in 26 patients, the posterior circulation in 13 patients, the anterior communicating artery in 5 patients, and the internal carotid artery terminus in 1 patient. Forty-two aneurysms were unruptured. Good clinical outcome (mRS < 2) was observed in 93.3% of patients at the last follow-up. Adequate occlusion (complete occlusion, opacification of the proximal recess, or neck remnant) was observed in 30/37 patients (81.1%) in short-term follow-up (median, 6 months) and in 26/29 patients (89.7%) in midterm follow-up (median, 13 months). Worsening of the aneurysm occlusion was observed in 2/28 patients (7.1%) at midterm follow-up.

CONCLUSIONS: The results suggest that the WEB endovascular treatment of wide-neck bifurcation aneurysms offers stable occlusion in a class of aneurysms that are historically unstable. Additionally, our data show that opacification of the WEB recess can be delineated from true neck or aneurysm remnants.

ABBREVIATIONS:

WEB-DL
WEB Dual Layer
WEB-SL
WEB Single Layer
WEB-SLS
WEB Single Layer Sphere
CLARITY
Clinical and Anatomical Results in the Treatment of Ruptured Intracranial Aneurysms.
  • © 2014 by American Journal of Neuroradiology

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American Journal of Neuroradiology: 35 (3)
American Journal of Neuroradiology
Vol. 35, Issue 3
1 Mar 2014
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WEB-DL Endovascular Treatment of Wide-Neck Bifurcation Aneurysms: Short- and Midterm Results in a European Study
B. Lubicz, J. Klisch, J.-Y. Gauvrit, I. Szikora, M. Leonardi, T. Liebig, N.P. Nuzzi, E. Boccardi, F.D. Paola, M. Holtmannspötter, W. Weber, E. Calgliari, V. Sychra, B. Mine, L. Pierot
American Journal of Neuroradiology Mar 2014, 35 (3) 432-438; DOI: 10.3174/ajnr.A3869

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WEB-DL Endovascular Treatment of Wide-Neck Bifurcation Aneurysms: Short- and Midterm Results in a European Study
B. Lubicz, J. Klisch, J.-Y. Gauvrit, I. Szikora, M. Leonardi, T. Liebig, N.P. Nuzzi, E. Boccardi, F.D. Paola, M. Holtmannspötter, W. Weber, E. Calgliari, V. Sychra, B. Mine, L. Pierot
American Journal of Neuroradiology Mar 2014, 35 (3) 432-438; DOI: 10.3174/ajnr.A3869
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