Neuroradiology

, Volume 56, Issue 9, pp 755–761

Woven Endobridge (WEB) Device for endovascular treatment of ruptured intracranial wide-neck aneurysms: a single-center experience

  • Jildaz Caroff
  • Cristian Mihalea
  • Francesco Dargento
  • Hiroaki Neki
  • Léon Ikka
  • Nidhal Benachour
  • Jacques Moret
  • Laurent Spelle
Interventional Neuroradiology

DOI: 10.1007/s00234-014-1390-7

Cite this article as:
Caroff, J., Mihalea, C., Dargento, F. et al. Neuroradiology (2014) 56: 755. doi:10.1007/s00234-014-1390-7

Abstract

Introduction

Endovascular treatment of ruptured wide-neck bifurcation aneurysms presents a challenge. While still under evaluation, the Woven Endobridge (WEB) aneurysm embolization system has so far shown promising results in the treatment of complex bifurcation aneurysms. We aimed to evaluate the feasibility and short-term follow-up of endovascular treatment of ruptured wide-neck aneurysm with the WEB device.

Methods

Six patients referred to our institution for acute symptomatic subarachnoid hemorrhage (SAH) and treated with the WEB device were enrolled in this study. Clinical presentations, technical details, intraoperative and postoperative complications, and outcomes were recorded. Immediate and 3-month angiographic results were also evaluated.

Results

Three middle cerebral artery (MCA) and three anterior communicating artery aneurysms were treated between 1 and 14 days after rupturing. Average dome width was 5.8 mm (range 5–7), average neck size was 4.5 mm (range 4–5), and average dome-to-neck ratio was 1.3 (range 1–1.7). The WEB system was the exclusive treatment and was successfully deployed in all cases. Per procedural thromboembolic events occurred in two cases and were treated with intra-arterial administration of antiplatelet agents without any clinical consequences. The modified Rankin Scale (mRS) score at discharge was 0 for all patients. The 3-month angiographic follow-up showed adequate occlusion in four of our six patients (67 %).

Conclusion

From this preliminary study, the high feasibility rate and lack of need for systematic antiplatelet agents favor the WEB device providing a solution for endovascular treatment of ruptured wide-neck bifurcation aneurysms during the acute phase. However, further studies are needed to evaluate the complication rate and long-term efficiency.

Keywords

Endovascular treatment Ruptured aneurysm Subarachnoid hemorrhage WEB Wide-neck bifurcation aneurysm 

Abbreviations

EVT

Endovascular treatment

WEB

Woven Endobridge

SAH

Subarachnoid hemorrhage

MCA

Middle cerebral artery

mRS

Modified Rankin Scale

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Jildaz Caroff
    • 1
    • 2
  • Cristian Mihalea
    • 1
  • Francesco Dargento
    • 1
  • Hiroaki Neki
    • 1
  • Léon Ikka
    • 1
  • Nidhal Benachour
    • 1
  • Jacques Moret
    • 1
    • 2
  • Laurent Spelle
    • 1
    • 2
  1. 1.Beaujon Medical CenterNEURI - Interventional NeuroradiologyClichyFrance
  2. 2.University Paris Diderot - Paris 7ParisFrance

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