Abstract
Purpose
Endovascular coil occlusion represents the standard treatment for basilar tip aneurysms. Recently, this role has been rivalled by intrasaccular flow disruptors across numerous centres. We retrospectively compared WEB embolization and coiling for the treatment of ruptured basilar tip aneurysms.
Methods
Patients treated with WEB or coiling at four neurovascular centres were reviewed. Procedure-related complications, clinical outcome, and angiographic results were retrospectively compared.
Results
The study included 23 patients treated with the WEB (aneurysm size: 6.6 ± 1.9 mm) and 56 by coiling (aneurysm size: 6.7 ± 2.5 mm). Stent-assistance was more often necessary with coiling than with WEB embolization (32% vs. 4%, p = 0.009). A modified Rankin scale score ≤ 2 at discharge had 21 (37.5%) patients in the coiling group and 12 (52.2%) in the WEB group (p = 0.235). Immediate complete and adequate occlusion rates were 52% for the WEB and 87% for coiling. At short-term follow-up, these rates were 87% for the WEB and 72% for coiling, respectively. There was no delayed aneurysm re-bleeding during follow-up.
Conclusion
Both coiling and WEB seem to prevent rebleeding in ruptured BTA aneurysms. WEB embolization required less frequently stent-support than coiling, potentially advantageous for SAH patients to avoid anti-platelet therapy in the light of concomitant procedures like ventricular drainage.
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Data availability
The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.
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CK serves as consultant for Acandis GmbH (Pforzheim, Germany) and as proctor for MicroVention Inc./Sequent Medical (Aliso Viejo, CA, USA). TL serves as proctor for MicroVention Inc./Sequent Medical (Aliso Viejo, CA, USA), CERUS Endovascular (Fremont, CA, USA), Phenox, Stryker, and Medtronic. The other authors declare no competing interests.
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The study protocol was approved by the local ethics committee of the University Hospital of Cologne. The need for informed consent was waived by the local ethics committee of the University Hospital of Cologne. The study was conducted in accordance with the STROBE guidelines in compliance with the national legislation and the Code of Ethical Principles for Medical Research Involving Human Subjects of the World Medical Association (Declaration of Helsinki).
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Celik, E., Goertz, L., Ozpeynirci, Y. et al. Comparative assessment of woven endobridge embolization and standard coil occlusion for the treatment of ruptured basilar tip aneurysms. Neuroradiology 65, 765–773 (2023). https://doi.org/10.1007/s00234-022-03096-4
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DOI: https://doi.org/10.1007/s00234-022-03096-4