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New Devices
Case series
Safety and efficiency of the fifth generation Woven EndoBridge device: technical note
  1. Cristian Mihalea1,2,
  2. Jildaz Caroff1,
  3. Igor Pagiola1,3,
  4. Leon Ikka1,
  5. Gelareh Bani Hashemi1,
  6. Soheil Naderi1,
  7. Vanessa Chalumeau1,
  8. Horia Ples2,
  9. Bogdan Valeriu Popa4,
  10. Thomas Yasuda1,
  11. Joaquin Jose Marenco de la Torre1,
  12. Marta Iacobucci1,
  13. Augustin Ozanne1,
  14. Sophie Gallas1,
  15. Aymeric Rouchaud5,
  16. Sorin Pescariu6,
  17. Jacques Moret1,
  18. Laurent Spelle1
  1. 1 Department of Interventional Neuroradiology Neuro Brain Vascular Center, Hopital Bicetre, APHP, Paris Sud Université, Le Kremlin-Bicetre, Île-de-France, France
  2. 2 Department of Neurosurgery, University of Medicine and Pharmacy ’Victor Babes', Timisoara, Romania
  3. 3 Department of Interventional Neuroradiology, Universidade Federal de São Paulo, São Paulo, Brasil
  4. 4 Department of Radiology and Medical Imaging, ’Floresca' Clinical Emergency Hospital, ’Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania
  5. 5 Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
  6. 6 Department of Cardiology, Victor Babes', University of Medicine and Pharmacy, Timisoara, Romania
  1. Correspondence to Dr Cristian Mihalea, Department of InterventionalNeuroradiology Neuro BrainVascular Center, Hopital Bicetre,APHP, Paris Sud Université, LeKremlin-Bicetre, Île-de-France,France; cristianmihalea{at}yahoo.com

Abstract

Backround The treatment of wide neck bifurcation aneurysms remains challenging despite the introduction of new techniques (Y stenting, waffle cone technique, or flow diverter stents). The Woven EndoBridge (WEB) device is an innovative solution for this type of cerebral aneurysm. A new WEB 17 is now available and has been designed to offer smaller sized devices to optimize navigability and delivery.

Methods Between February 2017 and April 2018 all patients treated with the WEB 17 device in our center were retrospectively reviewed. 25 patients with 28 non-ruptured aneurysms were identified and analyzed. Three patients with two aneurysms both treated with the WEB device were identified.

Results The device was successfully deployed in all cases. Procedure related morbidity was 4% and mortality was 0%. In one case, a delayed postprocedural thromboembolic event occurred owing to device protrusion. Technical success, complications, angiographic outcomes, procedural data, and follow-ups are reported. The modified Rankin Scale score at discharge was 0 for 24 patients (96%). At the 3, 6, or 9 month follow-up, angiograms were taken of 21 of the 25 patients (84%) (24 of 28 aneurysms had been controlled); 3 patients (3 aneurysms) did not receive angiographic follow-up at the time of submission of this work. Complete occlusion was achieved in 22 of 24 aneurysms (91.66%), and 2 of 24 aneurysm (8.33%) showed a neck remnant.

Conclusions The WEB 17 is safe and technically feasible, according to this retrospective single center analysis. For very small bifurcation aneurysms, the WEB 17 seems to have lower complication rates than stent assisted techniques. However, further studies are needed to evaluate the complication rate and long term efficiency.

  • aneurysm
  • device
  • intervention
  • technique

https://doi.org/10.1136/neurintsurg-2018-014343

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    Footnotes

    • Contributors All authors have contributed equally to this work. CM, JC, IP, LI, GBH, SN, VC, and HP: substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of the data for the work. TY, JMD, MI, AO, and SG: drafting the work or revising it critically for important intellectual content. AR, BVP, SP, JM, and LS: final approval of the version to be published. CM, JC, and IP: agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Correction notice Since this paper was first published online, Pr has been removed from the author names Sorin Pescariu, Jacques Moret and Laurent Spelle.