Middle Cerebral Artery Bifurcation Aneurysm: Wide-Necked Unruptured MCA Aneurysm Occlusion with Stent-Assisted WEB Implantation

  • Donald Lobsien
  • Joachim KlischEmail author
  • Christin Clajus
Living reference work entry


We report on a 68-year-old female patient who was diagnosed with a complex incidental aneurysm on the bifurcation of the right-hand middle cerebral artery (MCA) alongside a small aneurysm on the superior MCA trunk. It was decided to treat the complex aneurysm with stent-assisted implantation of a Woven Endobridge (WEB, MicroVention) with a stent also covering the small aneurysm. During the treatment, two stents did not open, had to be removed, and due to a WEB-induced stenosis of the inferior trunk, this branch had to be stented as a bail-out strategy. Ultimately, the large MCA aneurysm was closed, and although the small aneurysm on the superior branch had to be left untreated, on follow-up it was discovered that this had also closed due to the anatomical changes caused by the way the WEB-stent-construct had altered the hemodynamics in that area. Stent-assisted WEB treatment of a complex MCA aneurysm is the main topic of this chapter.


Middle cerebral artery Woven Endobridge, WEB MCA aneurysm Wide neck Solitaire stent LVIS jr. Bail-out strategy 


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Donald Lobsien
    • 1
  • Joachim Klisch
    • 1
    Email author
  • Christin Clajus
    • 1
  1. 1.Institut für diagnostische und interventionelle Radiologie und NeuroradiologieHELIOS Klinikum ErfurtErfurtGermany

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