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Use of a Woven Endobridge device (WEB) for the treatment of an aneurysmal diverticulum of the transverse sinus causing pulsatile tinnitus
  1. Areej Fageeh1,2,
  2. Gil Zur1,2,
  3. Ange Diouf1,2,
  4. Brian Drake1,2,3,4,
  5. Marlise P dos Santos1,2,3,4,
  6. Anne Lui2,4,5,
  7. Stephen Karwaski1,
  8. Chad Chenier1,
  9. Laurie Trussler1,
  10. Nancy Barnes1,
  11. Darren Tse2,4,6,
  12. David Schramm2,4,6,
  13. Howard Lesiuk1,2,3,4,
  14. Robert Fahed1,2,4,7
  1. 1Interventional Neuroradiology, Department of Medical Imaging, Ottawa Hospital, Ottawa, Ontario, Canada
  2. 2Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
  3. 3Neurosurgery, Department of Surgery, Ottawa Hospital, Ottawa, Ontario, Canada
  4. 4Ottawa Hospital Research Institute (OHRI, Ottawa Hospital, Ottawa, Ontario, Canada
  5. 5Anesthesia, Ottawa Hospital, Ottawa, Ontario, Canada
  6. 6Otolaryngology, Ottawa Hospital, Ottawa, Ontario, Canada
  7. 7Medicine - Neurology, Ottawa Hospital, Ottawa, Ontario, Canada
  1. Correspondence to Dr Areej Fageeh, Surgery - Neurosurgery and Interventional Neuroradiology, Ottawa Hospital, Ottawa, Ontario, Canada; Areejfaqih{at}


Pulsatile tinnitus is a symptom with a potentially significant impact on the quality of life of patients.1 In some cases the pulsatile tinnitus is secondary to an arterial, arteriovenous, or a venous condition that can be treated endovascularly.2–5 One of the newly recognized entities that can cause pulsatile tinnitus is the presence of an ipsilateral aneurysmal diverticulum of the transverse sinus. The Woven EndoBridge (WEB) is an intra-aneurysmal flow disruptor for the treatment of broad-based arterial aneurysms with a high safety and effectiveness profile.3 The initial version of the WEB with a dual-layer structure evolved into a single-layer structure in two different versions (WEB SL, a barrel shape, and WEB SLS, a spherical shape).4 The WEB system does not require concomitant antiplatelet therapy, unlike other intraluminal devices such as flow diverters or intracranial stents. We describe a case of pulsatile tinnitus secondary to an aneurysmal diverticulum of the transverse sinus successfully treated with a WEB SL device instead of stent-assisted coiling, therefore alleviating the need for antiplatelets (video 1). The patient had an immediate clinical response with complete and persisting disappearance of her pulsatile tinnitus.

Video 1 -

  • Aneurysm
  • Device
  • Technique
  • Intervention

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  • AF and GZ are joint first authors.

  • AF and GZ contributed equally.

  • Contributors All authors contributed significantly to 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 None declared.

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