Wide-Necked Bifurcation Aneurysm: Treatment with Woven EndoBridge (WEB) Device

  • Helen Cliffe
  • Tufail Patankar


A 62-year-old female was diagnosed with an incidental wide-necked anterior communicating artery (ACOM) aneurysm with partial involvement at the neck of the right A2 vessel (Fig. 36.1a) on CTA. Sequential CT scans demonstrated interval growth and the patient requested treatment. Endovascular management options include balloon-assisted coiling, stent-assisted coiling, and treatment with WEB (Sequent Medical Palo Alto, CA, USA). The alternatives were evaluated in the neurovascular multidisciplinary team meeting, and WEB was decided upon. Two attempts at elective WEB embolization were unsuccessful due to difficult access with tortuous internal carotids (Fig. 36.1b) and an angulated ICA/A1 junction bilaterally (Fig. 36.1c). A third attempt was planned (Figs. 36.2 and 36.3).

Suggested Reading

  1. Anil G, Goddard AJ, Ross SM, Deniz K, Patankar T. WEB in partially thrombosed intracranial aneurysms: a word of caution. Am J Neuroradiol. 2016;37(5):892–6.CrossRefGoogle Scholar
  2. Lawson A, Goddard T, Ross S, Tyagi A, Deniz K, Patankar T. Endovascular treatment of cerebral aneurysms using the Woven EndoBridge technique in a single center: preliminary results. J Neurosurg. 2017;126(1):17–28.CrossRefGoogle Scholar
  3. Lawson A, Molyneux A, Sellar R, Lamin S, Thomas A, Gholkar A, Patankar T. Safety results from the treatment of 109 cerebral aneurysms using the Woven EndoBridge technique: preliminary results in the United Kingdom. J Neurosurg. 2018;128:144–53.CrossRefGoogle Scholar
  4. Lubicz B, Klisch J, Gauvrit JY, Szikora I, Leonardi M, Liebig T, Nuzzi NP, Boccardi E, Paola FD, Holtmannspötter M, Weber W. WEB-DL endovascular treatment of wide-neck bifurcation aneurysms: short-and midterm results in a European study. Am J Neuroradiol. 2014;35(3):432–8.CrossRefGoogle Scholar
  5. Lubicz B, Mine B, Collignon L, Brisbois D, Duckwiler G, Strother C. WEB device for endovascular treatment of wide-neck bifurcation aneurysms. Am J Neuroradiol. 2013;34(6):1209–14.CrossRefGoogle Scholar
  6. Pierot L, Liebig T, Sychra V, Kadziolka K, Dorn F, Strasilla C, Kabbasch C, Klisch J. Intrasaccular flow-disruption treatment of intracranial aneurysms: preliminary results of a multicenter clinical study. Am J Neuroradiol. 2012;33(7):1232–8.CrossRefGoogle Scholar

Copyright information

© The Author(s) 2019

Authors and Affiliations

  • Helen Cliffe
    • 1
  • Tufail Patankar
    • 1
  1. 1.Leeds Teaching Hospitals NHS TrustLeedsUK

Personalised recommendations