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WEB Treatment of Ruptured Intracranial Aneurysms

WEB Treatment of Ruptured Intracranial Aneurysms BACKGROUND AND PURPOSE: The Woven EndoBridge (WEB) device was recently introduced for intrasaccular treatment of wide-neck aneurysms without the need for adjunctive support. We present our first experience in using the WEB for small ruptured aneurysms. MATERIALS AND METHODS: During 11 months, 32 of 71 (45%) endovascularly treated acutely ruptured aneurysms were treated with the WEB. The patients were 12 men and 20 women, with a mean age of 61 years (range, 34–84 years). The mean aneurysm size was 4.9 mm, and 14 were ≤4 mm. Of 32 aneurysms, 24 (75%) had a wide neck. RESULTS: All 32 aneurysms were adequately occluded after WEB placement. There were no procedural ruptures and no complications related to the WEB device. No adjunctive stents or balloons were needed. In 3 patients, thromboembolic complications occurred. One patient developed an infarction, and 2 patients were asymptomatic. The procedural complication rate was 3%. Seven patients admitted in poor clinical grade conditions died during hospital admission due to the sequelae of SAH. In 18 patients with angiographic follow-up at 3 months, 16 aneurysms remained adequately occluded. Two aneurysms showed slight compression of the WEB without reopening. Clinical follow-up in the 25 patients who survived the hospital admission period revealed mRS 1–2 in 24 and mRS 4 in 1. There were no rebleeds from the ruptured aneurysms during follow-up. CONCLUSIONS: WEB treatment of small ruptured aneurysms was safe and effective without the need for anticoagulation, adjunctive stents, or balloons. Our preliminary experience indicates that the WEB may be a valuable alternative to coils in the treatment of acutely ruptured aneurysms. ABBREVIATIONS: DL Dual-Layer SL Single-Layer SLS Single-Layer Sphere WEB Woven EndoBridge http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

WEB Treatment of Ruptured Intracranial Aneurysms

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Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2016 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A4811
pmid
27102307
Publisher site
See Article on Publisher Site

Abstract

BACKGROUND AND PURPOSE: The Woven EndoBridge (WEB) device was recently introduced for intrasaccular treatment of wide-neck aneurysms without the need for adjunctive support. We present our first experience in using the WEB for small ruptured aneurysms. MATERIALS AND METHODS: During 11 months, 32 of 71 (45%) endovascularly treated acutely ruptured aneurysms were treated with the WEB. The patients were 12 men and 20 women, with a mean age of 61 years (range, 34–84 years). The mean aneurysm size was 4.9 mm, and 14 were ≤4 mm. Of 32 aneurysms, 24 (75%) had a wide neck. RESULTS: All 32 aneurysms were adequately occluded after WEB placement. There were no procedural ruptures and no complications related to the WEB device. No adjunctive stents or balloons were needed. In 3 patients, thromboembolic complications occurred. One patient developed an infarction, and 2 patients were asymptomatic. The procedural complication rate was 3%. Seven patients admitted in poor clinical grade conditions died during hospital admission due to the sequelae of SAH. In 18 patients with angiographic follow-up at 3 months, 16 aneurysms remained adequately occluded. Two aneurysms showed slight compression of the WEB without reopening. Clinical follow-up in the 25 patients who survived the hospital admission period revealed mRS 1–2 in 24 and mRS 4 in 1. There were no rebleeds from the ruptured aneurysms during follow-up. CONCLUSIONS: WEB treatment of small ruptured aneurysms was safe and effective without the need for anticoagulation, adjunctive stents, or balloons. Our preliminary experience indicates that the WEB may be a valuable alternative to coils in the treatment of acutely ruptured aneurysms. ABBREVIATIONS: DL Dual-Layer SL Single-Layer SLS Single-Layer Sphere WEB Woven EndoBridge

Journal

American Journal of NeuroradiologyAmerican Journal of Neuroradiology

Published: Sep 1, 2016

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