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Technical video
WEB for recurrent aneurysms: a case series to review technical nuances
  1. Ryan Holland1,
  2. Muhammed Amir Essibayi2,
  3. David Altschul2
  1. 1 Department of Neurosurgery, Montefiore Medical Center, Bronx, New York, USA
  2. 2 Montefiore Einstein Cerebrovascular Research Lab, Montefiore Medical Center, New York, New York, USA
  1. Correspondence to Dr David Altschul, Department of Neurosurgery, Montefiore Medical Center, New York, New York, USA; DALTSCHU{at}montefiore.org

Abstract

Recurrent intracranial aneurysms (IAs) often present with more complex morphology such as irregular shape, shallow height, and wide neck, which can make for challenging endovascular treatments.1 Initial rupture and interventions are associated with fibrotic changes and considerable alteration in the aneurysm configuration, which limits retreatment options and increases the risk of complications during retreatment.2 The Woven Endobridge (WEB) embolization device has demonstrated high efficacy, flexibility, and safety for the treatment of wide-neck bifurcation IAs, including ruptured and recurrent IAs, as shown in multiple retrospective studies and meta-analyses.3–8 Due to its optimal barrel shape, the WEB device is useful in the setting of previously treated aneurysms, particularly with wide-neck previously coiled aneurysms.1 9 10 In this technical video of four cases (video 1), we describe the technical nuances of WEB embolization for recurrent IAs, which were initially either coiled or clipped and demonstrated progressive growth with a wide-neck presentation on follow-up.

Video 1 Management of recurrent intracranial aneurysms via WEB: This video describes four recurrent intracranial aneurysms, which were initially either coiled or clipped but demonstrated progressive growth with a wide-neck presentation on follow-up. All cases were successfully treated via WEB.
  • Aneurysm
  • Flow Diverter
  • Subarachnoid

https://doi.org/10.1136/jnis-2023-020633

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    Footnotes

    • Twitter @MAEssibayi, @davidaltschulmd

    • RH and MAE contributed equally.

    • Contributors RH and MAE contributed equally to material preparation, writing, technical preparation, and manuscript execution. DA contributed to writing, technical preparation, manuscript execution, and supervision.

    • 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.

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

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