Skip to main content
Log in

Woven Endobridge (WEB) device for endovascular treatment of complex unruptured aneurysms—a single center experience

  • Interventional Neuroradiology
  • Published:
Neuroradiology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

UIA:

Unruptured intracranial aneurysms

WEB:

Woven Endobridge

AComA:

Anterior communicating artery

MCA:

Middle cerebral artery

BA:

Basilar artery

VA:

Vertebral artery

References

  1. Ding YH, Lewis DA, Kadirvel R, Dai D, Kallmes DF (2011) The Woven EndoBridge: a new aneurysm occlusion device. Am J Neuroradiol 32:607–611

    Article  CAS  PubMed  Google Scholar 

  2. Klisch J, Sychra V, Strasilla C, Liebig T, Fiorella D (2011) The Woven EndoBridge cerebral aneurysm embolization device (WEB II): initial clinical experience. Neuroradiology 53:599–607

    Article  PubMed  Google Scholar 

  3. Pierot L, Liebig T, Sychra V, Kadziolka K, Dorn F, Strasilla C, Kabbasch C, Klisch J (2012) Intrasaccular flowdisruption treatment of intracranial aneurysms: preliminary results of a multicenter clinical study. Am J Neuroradiol 33:1232–1238

    Article  CAS  PubMed  Google Scholar 

  4. Pierot L, Klisch J, Cognard C, Szikora I, Mine B, Kadziolka K, Sychra V, Gubucz I, Januel AC, Lubicz B (2013) Endovascular WEB Flow disruption in middle cerebral artery aneurysms: preliminary feasibility, clinical, and anatomical results in a multicenter study. Neurosurgery 73:27–35

    Article  PubMed  Google Scholar 

  5. Lubicz B, Mine B, Collignon L, Brisbois D, Duckwiler G, Strother C (2013) WEB device for endovascular treatment of wide-neck bifurcation aneurysms. Am J Neuroradiol 34:1209–1214

    Article  CAS  PubMed  Google Scholar 

  6. Pierot L, Klisch J, Liebig T, Gauvrit JY, Leonardi M, Nuzzi NP, Di Paola F, Sychra V, Mine B, Lubicz B. (2015) WEB-DL Endovascular Treatment of Wide-Neck Bifurcation Aneurysms: Long-Term Results in a European Series. Am J Neuroradiol.

  7. Liebig T, Kabbasch C, Strasilla C, Berlis A, Weber W, Pierot L, Patankar T, Barreau X, Dervin J, Kuršumović A, Rath S, Lubicz B, Klisch J (2015) Intrasaccular flow disruption in acutely ruptured aneurysms: a multicenter retrospective review of the use of the web. Am J Neuroradiol 36:1721–1727

    Article  CAS  PubMed  Google Scholar 

  8. Behme D, Berlis A, Weber W (2015) Woven EndoBridge intrasaccular flow disrupter for the treatment of ruptured and unruptured wide-neck cerebral aneurysms: report of 55 cases. Am J Neuroradiol 36:1501–1506

    Article  CAS  PubMed  Google Scholar 

  9. Caroff J, Mihalea C, Dargento F, Neki H, Ikka L, Benachour N, Moret J, Spelle L (2014) Woven Endobridge (WEB) Device for endovascular treatment of ruptured intracranial wide-neck aneurysms: a single-center experience. Neuroradiology 56:755–761

    Article  PubMed  Google Scholar 

  10. Lubicz B, Klisch J, Gauvrit JY, Szikora I, Leonardi M, Liebig T, Nuzzi NP, Boccardi E, Paola FD, Holtmannspötter M, Weber W, Calgliari E, Sychra V, Mine B, Pierot L (2014) WEB-DL endovascular treatment of wide-neck bifurcation aneurysms: short- and midterm results in a European study. Am J Neuroradiol 35:432–438

    Article  CAS  PubMed  Google Scholar 

  11. Leyon JJ, Chavda S, Lamin S (2015) Corking the WEB and coiling through a jailed microcatheter: WEB assisted coiling, a useful technique avoiding the use of stents in treating wide-necked large intracranial aneurysms. BMJ Case Rep 2:2015

    Google Scholar 

  12. Pierot L, Costalat V, Moret J, Szikora I, Klisch J, Herbreteau D, Holtmannspötter M, Weber W, Januel AC, Liebig T, Sychra V, Strasilla C, Cognard C, Bonafé A, Molyneux A, Byrne JV, Spelle L (2015) Safety and efficacy of aneurysm treatment with WEB: results of the WEBCAST study. J Neurosurg 18:1–7

    Article  Google Scholar 

  13. Papagiannaki C, Spelle L, Januel AC, Benaissa A, Gauvrit JY, Costalat V, Desal H, Turjman F, Velasco S, Barreau X, Courtheoux P, Cognard C, Herbreteau D, Moret J, Pierot L (2014) WEB intrasaccular flow disruptor-prospective, multicenter experience in 83 patients with 85 aneurysms. Am J Neuroradiol 35:2106–2111

    Article  CAS  PubMed  Google Scholar 

  14. Pierot L, Spelle L, Molyneux A, Byrne J, WEBCAST and French Observatory Investigators (2016) Clinical and anatomical follow-up in patients with aneurysms treated with the WEB device: 1-year follow-up report in the cumulated population of 2 prospective, multicenter series (WEBCAST and french observatory). Neurosurgery 78:133–141

    Article  PubMed  Google Scholar 

  15. Pierot L, Moret J, Turjman F, Herbreteau D, Raoult H, Barreau X, Velasco S, Desal H, Januel AC, Courtheoux P, Gauvrit JY, Cognard C, Molyneux A, Byrne J, Spelle L. (2015) WEB Treatment of Intracranial Aneurysms: Clinical and Anatomic Results in the French Observatory. Am J Neuroradiol.

  16. Cognard C, Januel AC (2015) Remnants and recurrences after the use of the WEB intrasaccular device in large-neck bifurcation aneurysms. Neurosurgery 76:522–530

    Article  PubMed  Google Scholar 

  17. Caroff J, Mihalea C, Klisch J, Strasilla C, Berlis A, Patankar T, Weber W, Behme D, Jacobsen EA, Liebig T, Prothmann S, Cognard C, Finkenzeller T, Moret J, Spelle L (2015) Single-layer WEBs: intrasaccular flow disrupters for aneurysm treatment-feasibility results from a european study. Am J Neuroradiol 36:1942–1946

    Article  CAS  PubMed  Google Scholar 

  18. Tsutsumi K, Ueki K, Morita A, Usui M, Kirino T (2001) Risk of aneurysm recurrence in patients with clipped cerebral aneurysms: results of long-term follow-up angiography. Stroke 32:1191–1194

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Stephanie Lescher.

Ethics declarations

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.

Conflict of interest

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.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00234-016-1641-x

Keywords

Navigation