Long-Term Outcomes of the WEB Device for Treatment of Wide-Neck Bifurcation Aneurysms

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With a mean follow-up of approximately 15 months, the authors evaluated 41 cases of wide-neck aneurysms. Overall, 78.8% of the aneurysms had complete occlusion in the last follow-up, and 19.5% required retreatment with additional endovascular devices. A good clinical outcome (mRS: 0–2) was obtained in 95.1% of the patients, and the overall treatment-related morbidity and mortality rates were 2.4% and 0.0%, respectively. They conclude that treatment of wide-neck bifurcation aneurysms with a WEB device is feasible with an acceptable safety and efficacy rate.

Abstract

BACKGROUND AND PURPOSE

Figure 1 from Fujimoto et al
A, Angiogram shows right MCA bifurcation aneurysm with a wide neck. B, The WEB device protruding into the parent artery is causing flow reduction in the M2 segment. C, Radiograph demonstrating an LVIS stent (MicroVention) placed in the MCA elevates the distal edge of the WEB device.

Treatment of wide-neck bifurcation aneurysms using endovascular therapy is still challenging even with the development of treatment devices. The purpose of this investigation was to assess the safety and efficacy of treatment with a Woven EndoBridge (WEB) device for wide-neck bifurcation aneurysms.

MATERIALS AND METHODS

All patients treated with a WEB device at our institution between May 2009 and November 2016 were retrospectively evaluated. Clinical and imaging evaluation, aneurysm occlusion status, and modified Rankin scale score were analyzed 1 day after treatment and in the short- (<6 months), mid- (<24 months), and long-term (>24 months) follow-up periods.

RESULTS

Forty-one cases of wide-neck aneurysms were analyzed in this study. Overall, 78.8% of the aneurysms had complete occlusion in the last follow-up, and 19.5% required retreatment with additional endovascular devices. A good clinical outcome (modified Rankin scale: 0–2) was obtained in 95.1% of the patients, and the overall treatment-related morbidity and mortality rates were 2.4% and 0.0%, respectively. The mean follow-up time was 15.3 ± 13.5 months.

CONCLUSIONS

The results obtained in this study suggest that treatment of wide-neck bifurcation aneurysms with a WEB device is feasible with an acceptable safety and efficacy rate.

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Long-Term Outcomes of the WEB Device for Treatment of Wide-Neck Bifurcation Aneurysms
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Jeffrey Ross
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