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Original research
WEB device for treatment of posterior communicating artery aneurysms
  1. Guilherme Aguiar1,
  2. Jildaz Caroff1,
  3. Cristian Mihalea1,
  4. Jonathan Cortese1,
  5. Jean-Baptiste Girot1,
  6. Ahmed Elawady1,
  7. Jeickson Vergara Martinez1,
  8. Léon Ikka1,
  9. Sophie Gallas1,
  10. Vanessa Chalumeau1,
  11. Augustin Ozanne1,
  12. Jacques Moret1,
  13. Laurent Spelle1,2
  1. 1NEURI - Neurointerventional Radiology, Bicêtre Hospital, Hôpitaux Universitaires Paris-Sud, Assistance Publique Hôpitaux de Paris (APHP), Le Kremlin-Bicetre, France
  2. 2Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicetre, France
  1. Correspondence to Dr Jildaz Caroff, NEURI - Neurointerventional Radiology, Bicêtre Hospital, Hôpitaux Universitaires Paris-Sud, Assistance Publique Hôpitaux de Paris (APHP), Le Kremlin-Bicetre, France; jildaz.caroff{at}aphp.fr

Abstract

Background Woven EndoBridge (WEB) device treatment of wide-neck bifurcation aneurysms has proved to be safe and effective, but the use of these devices in sidewall aneurysms has been reported only in a small number of case series.

Objective To report our results in a cohort of consecutive patients in whom a WEB device was used as first-line treatment for posterior communicating artery (PComA) aneurysms.

Methods We conducted a retrospective analysis of a prospectively maintained database of PComA aneurysms treated with a WEB device in our institution from June 1, 2012 to November 15, 2020. Clinical and radiological findings were evaluated at immediate and last follow-up.

Results A total of 219 aneurysms were treated with a WEB device, including 15 PComA aneurysms in 15 patients, 10 of which were ruptured. Aneurysms were wide necked, with a mean aspect ratio of 1.6 (range 0.7–3.0) and a mean neck size of 4.2 mm (range 2.6–7.4 mm). No intraoperative rupture occurred and only one thromboembolic event was noted. Among the group with at least a 3-month digital subtraction angiography (DSA) follow-up, complete and adequate occlusion were obtained in 54% and 72%, respectively (average follow-up 13 months). Re-treatment was needed for two initially ruptured aneurysms. No procedure-related morbidity or mortality was reported.

Conclusion This series suggests the high safety profile of WEB devices even when used in off-label indications. Treatment with these devices seems to be a valuable strategy for ruptured wide-neck PComA aneurysms, avoiding the need for antiplatelet medication. However, occlusion rates should be investigated in further larger studies.

  • Aneurysm
  • Intervention
  • Device
  • Angiography

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Twitter @jildazz, @CRISTIANMIHALEA, @doc soph

  • GA and JC contributed equally.

  • Contributors GA and JCa contributed to conception and design of the study, drafting the manuscript. JCa, JCo, and J-BG contributed to data collection and analysis. JM and LS contributed to revising the manuscript for important intellectual content. All authors approved the final version to be published.

  • 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 JCa has received educational scholarships from Medtronic Neurovascular and Microvention/Terumo in 2017. JM is a consultant for Microvention, Medtronic, and Balt. LS is a consultant for Stryker, Microvention, Medtronic, and Balt.

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

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