Abstract
Introduction
The introduction of the Woven Endobridge (WEB) device increases the feasibility of endovascular treatment of wide-neck bifurcation aneurysms with limitations given by currently available sizes and shapes of the device. Parallel to other studies, we used the new device for selected patients who were no optimal candidates for established techniques like neurosurgical clipping or endovascular coiling. We aimed to report the angiographic and clinical results of WEB implantations or combinations between WEB and coiling or intracranial stents.
Methods
We reviewed the records of n = 23 interventions in 22 patients with unruptured wide-neck aneurysms (UIA) who were assigned for aneurysm treatment with the use of the WEB or adjunctive techniques. Interventional procedures and clinical and angiographic outcomes are reported for the periprocedural phase and in mid-term FU.
Results
Of the included 22 patients, six patients needed additional coiling, intracranial stenting, or implantation of a flow diverter. WEB implantation was technically feasible in 22 out of the 23 interventions. Follow-up angiographic imaging proved total or subtotal occlusion of the aneurysm in 19 of 22 cases. Two minor recurrences remained stable during a period of 15 months. One patient with a partially thrombosed giant MCA aneurysm had a major recurrence and was retreated with a second WEB in combination with coiling.
Conclusion
Despite of unfavorable anatomic conditions, broad-based and large UIA endovascular treatment with the WEB and adjunctive techniques was feasible with a low risk of complications and promising occlusion rates in mid-term follow-up.
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Abbreviations
- UIA:
-
Unruptured intracranial aneurysms
- WEB:
-
Woven Endobridge
- AComA:
-
Anterior communicating artery
- MCA:
-
Middle cerebral artery
- BA:
-
Basilar artery
- VA:
-
Vertebral artery
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We declare that all human and animal studies have been approved by the local Ethics Committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.
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JB consults for and receives honorarium as a proctor for WEB. There is a permanent scientific cooperation with Siemens Healthcare GmbH, and travel expenses for presentation of projects are covered by the company.
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Lescher, S., du Mesnil de Rochemont, R. & Berkefeld, J. Woven Endobridge (WEB) device for endovascular treatment of complex unruptured aneurysms—a single center experience. Neuroradiology 58, 383–390 (2016). https://doi.org/10.1007/s00234-016-1641-x
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DOI: https://doi.org/10.1007/s00234-016-1641-x