RT Journal Article
SR Electronic
T1 Intrasaccular Flow Disruption in Acutely Ruptured Aneurysms: A Multicenter Retrospective Review of the Use of the WEB
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1721
OP 1727
DO 10.3174/ajnr.A4347
VO 36
IS 9
A1 T. Liebig
A1 C. Kabbasch
A1 C. Strasilla
A1 A. Berlis
A1 W. Weber
A1 L. Pierot
A1 T. Patankar
A1 X. Barreau
A1 J. Dervin
A1 A. Kuršumović
A1 S. Rath
A1 B. Lubicz
A1 J. Klisch
YR 2015
UL http://www.ajnr.org/content/36/9/1721.abstract
AB BACKGROUND AND PURPOSE: Use of the WEB intra-aneurysmal flow-disruption device in unruptured wide-neck bifurcation aneurysms has proven safety and efficacy. However, ruptured aneurysms are underrepresented in existing studies. This retrospective multicenter study describes the use of the WEB in patients with a ruptured intracranial aneurysm.MATERIALS AND METHODS: Ten centers contributed to this study. Clinical and procedural data of 47 patients with 52 aneurysms were analyzed retrospectively together with follow-up angiographies.RESULTS: There were 37 anterior and 15 posterior circulation aneurysms with a neck size of ≥4 mm in 49 of 52 (94%) aneurysms; 45 (87%) aneurysms were <10 mm, and 2 were partially thrombosed. Successful placement of the WEB was possible in every case. Adjunctive devices were used in 8 of 52 (15%) aneurysms. Thromboembolic events were observed in 4 of 52 (8%) patients. Adverse events occurred in 15 patients with 16 aneurysms, 9 of which were potentially related to the WEB procedure (3 thromboembolic events, 5 protrusions, and 1 perforations; 2 perforations were caused by the wire or catheter), but none had a clinical impact. Four patients were retreated. Short-term follow-up in 25 of 39 patients revealed complete occlusion in 15 of 25 (60%), 5 of 25 (20%) with residual neck, and 5 of 25 (20%) with residual aneurysm filling. Short- to midterm imaging in 9 of 25 patients revealed complete occlusion in 5 (55.6%), residual neck in 2 (22%), and residual aneurysm filling in 2 (22%). Of 47 patients, 23 (49%) had an mRS score of 0, 1, or 2; 13 (28%) had an mRS score of 3 or 4; and none had an mRS score of 5 at discharge.CONCLUSIONS: This retrospective series showed good procedural safety, feasibility, and stability of midterm occlusion in ruptured wide-neck bifurcation aneurysms.CLARITYClinical and Anatomical Results In the Treatment of Ruptured Intracranial AneurysmsHHHunt and HessATENAAnalysis of Treatment by Endovascular Approach of Nonruptured Aneurysms