The occlusion time of cerebral aneurysms treated with flow diverters can be predicted by the hemodynamic conditions created immediately after device implantation. Specifically, low post-implantation flow velocity, inflow rate, and shear rate are associated with fast occlusion times.

BACKGROUND AND PURPOSE: Treatment of wide-neck bifurcation aneurysms using endovascular therapy is still challenging even with the development of treatment devices. The purpose of this investigation was to assess the safety and efficacy of treatment with a Woven EndoBridge (WEB) device for wide-neck bifurcation aneurysms. MATERIALS AND METHODS:All patients treated with a WEB device at our institution between May 2009 and November 2016 were retrospectively evaluated. Clinical and imaging evaluation, aneurysm occlusion status, and modified Rankin scale score were analyzed 1 day after treatment and in the short-(,6 months), mid-(,24 months), and long-term (.24 months) follow-up periods.RESULTS: Forty-one cases of wide-neck aneurysms were analyzed in this study. Overall, 78.8% of the aneurysms had complete occlusion in the last follow-up, and 19.5% required retreatment with additional endovascular devices. A good clinical outcome (modified Rankin scale: 0-2) was obtained in 95.1% of the patients, and the overall treatment-related morbidity and mortality rates were 2.4% and 0.0%, respectively. The mean follow-up time was 15.3 6 13.5 months. CONCLUSIONS:The results obtained in this study suggest that treatment of wide-neck bifurcation aneurysms with a WEB device is feasible with an acceptable safety and efficacy rate. ABBREVIATIONS: IA ¼ intracranial aneurysm; WEB ¼ Woven EndoBridge; WEB-DL ¼ Woven EndoBridge Dual-Layer; WEB-SL/SLS ¼ Woven EndoBridge Single-Layer and Single-Layer Sphere; AcomA ¼ anterior communicating artery I n recent years, an improvement in devices and techniques has resulted in an increase in endovascular treatment of intracranial aneurysms (IAs). Although the efficacy of endovascular therapy has been recognized widely, wide-neck bifurcation aneurysms still are considered unsuitable for endovascular therapy because of unfavorable geometry or daughter-vessel involvement. [1][2][3][4] Recently, the promising efficacy and safety profile of the novel Woven EndoBridge (WEB) device (Sequent Medical) for wideneck bifurcation aneurysm treatment has been published in major clinical studies. 5,6 However, only a few case series have reported the long-term follow-up results for this device; therefore, the long-term results still remain to be determined. 7 The purpose of this study was to analyze the mid-and longterm results of wide-neck bifurcation aneurysms treated with the WEB device and assess its safety and efficacy profile.

The p48 is a low-profile, intermediate-porosity flow diverter. phenox GmbHtrademarked hydrophilic polymer coating (pHPC) is a hydrophilic coating that has been shown in vitro to reduce the thrombogenicity of nitinol device surfaces. We performed the present study to determine whether the p48_HPC can be implanted using prasugrel alone. Methods: We retrospectively identified all patients who were treated with the p48_HPC from January 2017 to December 2018 (n ¼ 5) and underwent single antiplatelet therapy (SAPT) with prasugrel. P2Y12 inhibition was confirmed by the VerifyNow assay. The occurrence of thromboembolic and haemorrhagic complications was recorded alongside the occlusion rates of the treated aneurysms. Results: All patients achieved adequate occlusion (Raymond-Roy Occlusion Classification I or II) during the follow-up period. No thromboembolic complications occurred. One patient developed a contained haematoma within the Sylvian fissure from the treated aneurysm 2 weeks postoperatively without clinical sequelae. Conclusions: In this small series, no thromboembolic complications occurred in patients treated with the surface modified p48_HPC flow diverter and SAPT. Further studies with longer follow-up periods and larger cohorts should be performed.

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Background and Purpose The use of flow diverters to treat aneurysms arising from small caliber parent vessels has been reported. This article reports the results of the first in experiences with the p48MW (p48 Movable Wire) in humans, a device specifically designed to target vessels 1.75-3 mm in diameter. Methods This monocentric study retrospectively reviewed the prospectively maintained database to identify all patients treated with the p48MW device between January 2017 and January 2019 at this institution. Patient demographics, aneurysm characteristics, angiographic and clinical follow-up were recorded as well as complications. Results A total of 25 patients (20 female) with an average age of 55 ± 12.9 years (range 34-84) with 25 aneurysms were identified. The majority of the aneurysms was located in the anterior circulation (19/25, 76%). The average aneurysm dome width was 3.98 ± 3.6 mm (range 1.2-13 mm). Complete occlusion was seen in 18/24 (75%) aneurysms with neck remnants in 1/24 (4.2%) and continued aneurysm filling seen in the remaining cases (5/24, 20.8%). Adequate occlusion was seen in 79.2% of aneurysms (Raymond Roy Classification [RRC] grade I or II) during the follow-up period. There was a single technical complication with inappropriate deployment of the first p48MW. There was a single clinical complication (4%); however, the patient made a complete recovery (modified Rankin Scale [mRS] 0) and one patient died secondary to uncontrollable status epilepticus following acute subarachnoid hemorrhage unrelated to the treatment. Conclusion The p48MW is safe and effective for the treatment of aneurysms including those arising from distal vessels.