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The Woven EndoBridge Cerebral Aneurysm Embolization Device (WEB II): initial clinical experience

  • Interventional Neuroradiology
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Abstract

Introduction

The Woven Endobridge (WEB II) device (Sequent Medical, Inc., Aliso Viejo, CA, USA) is an intra-saccular, oblate, braided-wire embolization device designed to provide flow disruption at the aneurysm neck–parent artery interface. The purpose of this study was to evaluate the acute and short-term performance of the WEB II device regarding the immediacy, degree, and durability of aneurysm occlusion in two patients.

Methods

The WEB II device was implanted in one patient with an unruptured MCA trifurcation aneurysm and one patient with an unruptured basilar tip aneurysm. The degree of intra-aneurysmal flow disruption was graded based on serial digital subtraction aneurysm angiography performed over 30 min immediately following device implantation and at 8 weeks. Immediate and 8-week post-treatment CT and 3-T MRI studies were also performed.

Results

Delivery and deployment of the WEB II device was technically straightforward and achieved without complications. Neither device required retrieval or repositioning after full deployment. There were no peri-procedural thrombembolic or hemorrhagic complications. In both cases, complete aneurysm occlusion was observed within minutes of device deployment. Short-term angiographic follow-up confirmed stable complete occlusion at 8 weeks.

Conclusion

Early technical and clinical results from the first WEB II cases have been encouraging and suggest that the intra-saccular deployment of self-expanding, compliant, cylindrical, high-density, braided metallic mesh constructs may represent a feasible approach for the endovascular treatment of cerebral aneurysms.

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References

  1. Akpek S, Arat A, Morsi H, Klucznick RP, Strother CM, Mawad ME (2005) Self-expandable stent-assisted coiling of wide-necked intracranial aneurysms: a single-center experience. AJNR Am J Neuroradiol 26:1223–1231

    PubMed  Google Scholar 

  2. Byrne JV, Sohn MJ, Molyneux AJ, Chir B (1999) Five-year experience in using coil embolization for ruptured intracranial aneurysms: outcomes and incidence of late rebleeding. J Neurosurg 90:656–663

    Article  PubMed  CAS  Google Scholar 

  3. Kurre W, Berkefeld J (2008) Materials and techniques for coiling of cerebral aneurysms: how much scientific evidence do we have? Neuroradiology 50:909–927

    Article  PubMed  CAS  Google Scholar 

  4. Pandey AS, Koebbe C, Rosenwasser RH, Veznedaroglu E (2007) Endovascular coil embolization of ruptured and unruptured posterior circulation aneurysms: review of a 10-year experience. Neurosurgery 60:626–636

    Article  PubMed  Google Scholar 

  5. Augsburger L, Farhat M, Reymond P et al (2009) Effect of flow diverter porosity on intraaneurysmal blood flow. Clin Neuroradiol 19:204–214

    Article  Google Scholar 

  6. Fiorella D, Woo HH, Albuquerque FC, Nelson PK (2008) Definitive reconstruction of circumferential, fusiform intracranial aneurysms with the pipeline embolization device. Neurosurgery 62:1115–1120, discussion 1120–1111

    Article  PubMed  Google Scholar 

  7. Fiorella D, Kelly ME, Albuquerque FC, Nelson PK (2009) Curative reconstruction of a giant midbasilar trunk aneurysm with the pipeline embolization device. Neurosurgery 4:212–217, discussion 217

    Article  Google Scholar 

  8. Kulcsár Z, Houdart E, Bonafé A et al (2011) Intra-aneurysmal thrombosis as a possible cause of delayed aneurysm rupture after flow-diversion treatment. AJNR Am J Neuroradiol 32:20–25

    Article  PubMed  Google Scholar 

  9. Nelson PK, Lylyk P, Szikora I, Wetzel SG, Wanke I, Fiorella D (2011) The pipeline embolization device for the intracranial treatment of aneurysms trial. AJNR Am J Neuroradiol 32:34–40

    Article  PubMed  CAS  Google Scholar 

  10. Szikora I, Berentei Z, Kulcsar Z et al (2010) Treatment of intracranial aneurysms by functional reconstruction of the parent artery: the Budapest experience with the pipeline embolization device. AJNR Am J Neuroradiol 1:1139–1147

    Article  Google Scholar 

  11. Ding YH, Lewis DA, Kadirvel R, Dai D, Kallmes DF (2011) The Woven EndoBridge: a new aneurysm occlusion device. AJNR Am J Neuroradiol 32:607–611

    Article  PubMed  CAS  Google Scholar 

  12. Lylyk P, Miranda C, Ceratto R et al (2009) Curative endovascular reconstruction of cerebral aneurysms with the pipeline embolization device: the Buenos Aires experience. Neurosurgery 64:632–642, discussion 642–633; quiz N636

    Article  PubMed  Google Scholar 

  13. Kwon SC, Ding YH, Dai D, Kadirvel R, Lewis DA, Kallmes DF (2010) Preliminary results of the luna aneurysm embolization system in a rabbit model: a new intrasaccular aneurysm occlusion device. AJNR Am J Neuroradiol 32:602–606. doi:10.3174/ajnr.A2314

    Article  PubMed  Google Scholar 

  14. Kang HS, Moon WJ, Roh HG et al (2008) MR angiographic evaluation is limited in intracranial aneurysms embolized with Nexus coils. Neuroradiology 50:171–178

    Article  PubMed  Google Scholar 

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Conflict of interest

J. Klisch consults to Sequent Medical, which manufactures the WEB II device.

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Correspondence to Joachim Klisch.

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Klisch, J., Sychra, V., Strasilla, C. et al. The Woven EndoBridge Cerebral Aneurysm Embolization Device (WEB II): initial clinical experience. Neuroradiology 53, 599–607 (2011). https://doi.org/10.1007/s00234-011-0891-x

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  • DOI: https://doi.org/10.1007/s00234-011-0891-x

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