PT - JOURNAL ARTICLE AU - B. Lubicz AU - J. Klisch AU - J.-Y. Gauvrit AU - I. Szikora AU - M. Leonardi AU - T. Liebig AU - N.P. Nuzzi AU - E. Boccardi AU - F.D. Paola AU - M. Holtmannspötter AU - W. Weber AU - E. Calgliari AU - V. Sychra AU - B. Mine AU - L. Pierot TI - WEB-DL Endovascular Treatment of Wide-Neck Bifurcation Aneurysms: Short- and Midterm Results in a European Study AID - 10.3174/ajnr.A3869 DP - 2014 Mar 01 TA - American Journal of Neuroradiology PG - 432--438 VI - 35 IP - 3 4099 - http://www.ajnr.org/content/35/3/432.short 4100 - http://www.ajnr.org/content/35/3/432.full SO - Am. J. Neuroradiol.2014 Mar 01; 35 AB - 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. WEB-DLWEB Dual LayerWEB-SLWEB Single LayerWEB-SLSWEB Single Layer SphereCLARITYClinical and Anatomical Results in the Treatment of Ruptured Intracranial Aneurysms.