You are here

Article Text

Article menu

Download PDFPDF

New Devices and Techniques
How to WEB: a practical review of methodology for the use of the Woven EndoBridge
  1. Nitin Goyal1,
  2. Daniel Hoit2,3,
  3. Julie DiNitto4,
  4. Lucas Elijovich1,3,
  5. David Fiorella5,
  6. Laurent Pierot6,
  7. Saleh Lamin7,
  8. Laurent Spelle8,
  9. Isil Saatci9,
  10. Saru Cekirge10,
  11. Adam S Arthur2,3
  1. 1 Neurology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
  2. 2 Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
  3. 3 Department of Neurosurgery, Semmes-Murphey Clinic, Memphis, Tennessee, USA
  4. 4 Department of Research Collaborations, Siemens Medical Solutions USA Inc, Hoffman Estates, Illinois, USA
  5. 5 Department of Neuroradiology, Stony Brook University Hospital, Stony Brook, New York, USA
  6. 6 Neuroradiology, Reims Champagne-Ardenne University, Reims, France
  7. 7 Department of Neuroradiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  8. 8 Neuroradiology, NEURI Center, Bicetre Hospital, APHP, Paris-Saclay University, Saint-Aubin, France
  9. 9 Radiology, Koru Hospital, Yuksek Ihtisas Universitesi, Ankara, Turkey
  10. 10 Radiology, Bayindir Hastanesi Kavaklidere, Ankara, Turkey
  1. Correspondence to Dr Adam S Arthur, Semmes-Murphey Clinic, Memphis, TN 38120, USA; aarthur{at}semmes-murphey.com

Abstract

Wide-necked bifurcation aneurysms (WNBAs) make up 26–36% of all brain aneurysms. Treatments for WNBAs pose unique challenges due to the need to preserve major bifurcation vessels while achieving a durable occlusion of the aneurysm. Intrasaccular flow disruption is an innovative technique for the treatment of WNBAs. The Woven EndoBridge (WEB) device is the only United States Food and Drug Administration approved intrasaccular flow disruption device. In this review article we discuss various aspects of treating WNBAs with the WEB device, including indications for use, aneurysm/device selection strategies, antiplatelet therapy requirement, procedural technique, potential complications and bailouts, and management strategies for residual/recurrent aneurysms after initial WEB treatment.

  • aneurysm
  • device
  • flow diverter
  • technique
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/neurintsurg-2019-015506

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Twitter @AdamArthurMD

    • Contributors All authors of this work met ICMJE criteria for authorship and made substantial contributions to the conception and design, acquisition of data, analysis and interpretation of data, drafting, critical revising, and final approval of this manuscript.

    • 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 NG reports no disclosures or conflict of interests. DH serves as a consultant for Covidien/Medtronic and Microvention outside of the submitted work and has received research support from Siemens. JD is an employee of Siemens Healthineers. LE serves as a consultant for Codman Neurovascular, Medtronic, MicroVention, Penumbra, Sequent, and Stryker outside of the submitted work. DF is a consultant for Balt, Marblehead, Medtronic, Stryker, Microvention, Stryker, Penumbra, and Cerenovus; receives research support from Cerenovus, Medtronic, Stryker, Siemens, Microvention, and Penumbra, and royalties from Codman; and is a stockholder for Marblehead, Neurogami, and Vascular Simulations outside of the submitted work. LP is a consultant for Balt, Microvention, Phenox, and Vesalio outside of the submitted work. SL is a consultant for Microvention, Medtronic, Stryker, Balt, Cerenovus, Cerus, Phenox, Neuroventures, and Oxford endovascular; and is a shareholder in Cerus endovascular outside of the submitted work. LS is a consultant for Balt, Microvention, Medtronic, Stryker and Cerenovus; receives research hospital support from Philips; and is a stockholder for Sensome and Sim & Cure outside of the submitted work. IS is a consultant for Medtronic and Sequent/Microvention outside of the published work. SC serves as consultant for Medtronic, and Sequent/MicroVention outside of the submitted work and is a stockholder in ELUM and NDI. ASA is a consultant for Balt, Johnson and Johnson, Leica, Medtronic, Microvention, Penumbra, Scientia, Siemens, and Stryker; receives research support from Microvention, Penumbra, and Siemens; and is a shareholder in Bendit, Cerebrotech, Endostream, Magneto, Marblehead, Neurogami, Serenity, Synchron, Triad Medical and Vascular Simulations outside of the submitted work.

    • Patient consent for publication Not required.

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