E ndovascular treatment is now the first-line treatment for both ruptured and unruptured aneurysms. 1,7,17 However, aneurysms with a complex anatomy (singularly wide-neck aneurysms) are in some cases untreatable or difficult to treat with standard coiling. For this reason, more complex endovascular techniques have been developed, such as balloon-assisted coiling, stent-assisted coiling, and flow diversion. 18Flow disruption is a new endovascular approach, which involves placement of an endosaccular device (WEB), abbreviatioNs ACoA = anterior communicating artery; BA = basilar artery; CCT = Cerecyte Coil Trial; DSA = digital subtraction angiography; ICA = internal carotid artery; ITT = intention to treat; MCA = middle cerebral artery; mRS = modified Rankin Scale; WEBCAST = WEB Clinical Assessment of Intrasaccular Aneurysm Therapy. obJective WEB is an innovative intrasaccular treatment for intracranial aneurysms. Preliminary series have shown good safety and efficacy. The WEB Clinical Assessment of Intrasaccular Aneurysm Therapy (WEBCAST) trial is a prospective European trial evaluating the safety and efficacy of WEB in wide-neck bifurcation aneurysms. methods Patients with wide-neck bifurcation aneurysms for which WEB treatment was indicated were included in this multicenter good clinical practices study. Clinical data including adverse events and clinical status at 1 and 6 months were collected and independently analyzed by a medical monitor. Six-month follow-up digital subtraction angiography was also performed and independently analyzed by a core laboratory. Success was defined at 6 months as complete occlusion or stable neck remnant, no worsening in angiographic appearance from postprocedure, and no retreatment performed or planned. results Ten European neurointerventional centers enrolled 51 patients with 51 aneurysms. Treatment with WEB was achieved in 48 of 51 aneurysms (94.1%). Adjunctive implants (coils/stents) were used in 4 of 48 aneurysms (8.3%). Thromboembolic events were observed in 9 of 51 patients (17.6%), resulting in a permanent deficit (modified Rankin Scale [mRS] Score 1) in 1 patient (2.0%). Intraoperative rupture was not observed. Morbidity (mRS score > 2) and mortality were 2.0% (1 of 51 patients, related to rupture status on entry to study) and 0.0% at 1 month, respectively. Success was achieved at 6 months in 85.4% of patients treated with WEB: 23 of 41 patients (56.1%) had complete occlusion, 12 of 41 (29.3%) had a neck remnant, and 6 of 41 (14.6%) had an aneurysm remnant. coNclusioNs The WEBCAST study showed good procedural and short-term safety of aneurysm treatment with WEB and good 6-month anatomical results.Clinical trial registration no.: NCT01778322 (clinicaltrials.gov) http://thejns.org/doi/abs/10.3171/2015.2.JNS142634

BACKGROUND AND PURPOSE:The endovascular treatment of intracranial aneurysms with unfavorable anatomy (large aneurysms, wide-neck) is frequently challenging and is also associated with a high incidence of significant recurrences. The WEB, an intrasaccular flow disrupter, was designed for use in this type of aneurysm. We report our early experience with this device in this multicenter study.

BACKGROUND AND PURPOSE:Use of the WEB intra-aneurysmal flow-disruption device in unruptured wide-neck bifurcation aneurysms has proven safety and efficacy. However, ruptured aneurysms are underrepresented in existing studies. This retrospective multicenter study describes the use of the WEB in patients with a ruptured intracranial aneurysm.

Early technical and clinical results from the first WEB II cases have been encouraging and suggest that the intra-saccular deployment of self-expanding, compliant, cylindrical, high-density, braided metallic mesh constructs may represent a feasible approach for the endovascular treatment of cerebral aneurysms.

This series confirms a high level of safety and efficacy of the WEB device for the treatment of wide-necked intracranial aneurysms.

The initial technical and clinical results of Solitaire AB stent-assisted coiling of different types of wide-necked aneurysms in the posterior circulation are highly encouraging, and this technique may improve the endovascular treatment of these aneurysms.

BACKGROUND AND PURPOSE:The safety and efficiency of the dual-layer Woven EndoBridge (WEB) device has already been published. However, this international multicenter study sought to evaluate the safety of single-layer devices, which are the newest generation of the WEB intrasaccular flow-disrupter family. They have been designed to offer smaller-sized devices with a lower profile to optimize navigability and delivery, which may, in turn, broaden their range of use.

BACKGROUND AND PURPOSE:Mechanical thrombectomy by using a single stent retriever system has demonstrated high efficacy for recanalization of large-artery occlusions in acute stroke. We aimed to evaluate the feasibility, safety, and efficacy of a novel double Solitaire stent retriever technique as an escalating treatment for occlusions that are refractory to first-line single stent retriever mechanical thrombectomy.