Purpose The Woven Endobridge (WEB) device (Sequent Medical, Inc., Aliso Viejo, CA) is an intrasaccular, braided-wire embolization device designed to provide flow disruption along the aneurysm neck.The purpose of this study was to evaluate the acute and chronic performance of the newest designed WEB devices using rabbit aneurysm model.
Methods Six Aliso WEB DL (Dual Layer with barrel configuration); six Aliso WEB SL (Single Layer with barrel configuration); and six Aliso WEB SLS (Single Layer Sphere with spherical configuration) were deployed in 18 elastase-inducedaneurysms in the rabbits and followedfor 3 months. Degree of aneurysm occlusion was graded on a 4-point scale from digital subtraction angiography (DSA): Grade 1, Complete Flow Cessation in which no flow of contrast into the neck or sac; Grade 2, Near Complete Flow Cessation in which no flow of contrast into the neck or sac but contrast fills in central area below the WEB; Grade 3, Incomplete Cessation in which some flow into the neck but no flow in the sac or WEB; Grade 4, Fully Patent Aneurysm in which flow into the sac and/or the WEB. Comparison of aneurysm occlusion was performed using a 3-point scale (stable, progressive and recanalization). All aneurysms were harvested for histologic analysis. Aneurysm sizes among groups using different devices were measured and analyzed using the Student’s t test.
Results Mean aneurysm sizes among three groups were not significantly different (p < 0.05). Near complete flow cessation was shown in 1 wide and 2 narrow neck aneurysms in DL group, 1 wide and 1 narrow aneurysms in SL group, and 2 wide neck aneurysms in SLS group. Complete flow cessation was found in 3 narrow neck aneurysms in SLS group comparing with 1 in SL group and none of the DL group aneurysms (See Figure 1). Aneurysm recanalization was found in 2 aneurysms of the SL group and 1 of the SLS group. Totally 11 (11/18, 61%) aneurysms indicated complete or near complete flow cessation, 15 (15/18, 83%) aneurysms indicated progressive occlusion. Histologic features include unorganized blood clot or organized loose connective tissue filling the aneurysm sac and endothelialized neointima or incompletely organized thrombus across the neck interface. Inflammation within aneurysm lumen was absent or minimal (as localized, patchy, chronic inflammatory foci).
Conclusion Progressive aneurysm occlusion can be achieved by using all the three types of devices. SLS may help to achieve complete aneurysm occlusion, especially in narrow neck aneurysms.
Disclosures Y. Ding: None. D. Dai: None. D. Schroeder: None. R. Kadirvel: None. D. Kallmes: None.
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