Should indications for WEB aneurysm treatment be enlarged? Report of a series of 20 patients with aneurysms in “atypical” locations for WEB treatment

Piérot, Laurent; Biondi, Alessandra; Narata, Ana-Paula; Mihalea, Cristian; Januel, Anne-Christine; Μεταξάς, Γεώργιος; Bibi, Richard; Caroff, Jildaz; Cognard, Christophe; Spelle, Laurent; Herbreteau, Denis

doi:10.1016/j.neurad.2016.12.011

Cited by 41 publications

(22 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The main indications for WEB treatment were the following: 1) unruptured and ruptured wide-ostium aneurysms difficult to treat with simple coiling; 2) aneurysms located at bifurcation points not amenable to treatment with coiling or balloon-assisted coiling and where a flow diverter may lead to the risk of covering bifurcation branches or perforators. In addition, due to the progressive enlargement of WEB indications 5 and on the basis of our own positive results, some small-neck or small-sized aneurysms were treated with the WEB.…”

Section: Indications For Webmentioning

confidence: 99%

Predicting Factors of Angiographic Aneurysm Occlusion after Treatment with the Woven EndoBridge Device: A Single-Center Experience with Midterm Follow-Up

Cagnazzo

Ahmed

Zannoni

et al. 2019

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

BACKGROUND AND PURPOSE: Flow disruption with the Woven EndoBridge is increasingly used for the treatment of intracranial aneurysms. We examined factors leading to aneurysm occlusion and Woven EndoBridge shape change during a midterm follow-up. MATERIALS AND METHODS: Patients with a minimum 12-month angiographic follow-up were included. Through a univariate and multivariate analysis, independent predictors of adequate occlusion (Raymond-Roy 1/Raymond-Roy 2) and Woven EndoBridge shape change (decrease of the height of the device) were assessed. RESULTS: Eighty-six patients/aneurysms were included. The aneurysm mean size was 5.5 mm (range, 3-11.5 mm). The most common locations were the MCA (43/86 ¼ 50%), basilar tip (13/86 ¼ 15.1%), and anterior communicating artery (12/86 = 14%). Twenty-one patients (21/86 ¼ 24%) had acute SAH. Immediate and long-term Raymond-Roy 1/Raymond-Roy 2 occlusion rates were 49% (42/86) and 80% (68/86), respectively. Woven EndoBridge shape change was detected among 22% (19/86) of cases. At binary logistic regression, wide ostium ($4 mm) (OR ¼ 0.2; 95% CI, 0.01-1; P ¼ .04) and regular aneurysm morphology (OR ¼ 5.9; 95% CI, 1.4-24; P ¼ .01) were independent factors of incomplete and adequate aneurysm occlusion, respectively. In addition, irregular morphology (OR = 5.4; 95%CI , 1.4-19; P ¼ .01) and a wide ostium (OR ¼ 9.8; 95% CI, 1.6-60; P ¼ .03) significantly increased the probability of the Woven EndoBridge shape change. Decrease of the Woven EndoBridge height was more common among incompletely occluded aneurysms (6/12 ¼ 50% versus 13/74 ¼ 17.5%), but it was not an independent prognosticator of occlusion at the multivariate model. CONCLUSIONS: The likelihood of good occlusion was 5 times lower in the presence of a wide ostium, whereas aneurysms with regular morphology were 6 times more likely to be occluded. Woven EndoBridge shape modification was strongly influenced by the aneurysm shape and ostium size, and it was not independently associated with the angiographic occlusion.

show abstract

Section: Indications For Webmentioning

confidence: 99%

Predicting Factors of Angiographic Aneurysm Occlusion after Treatment with the Woven EndoBridge Device: A Single-Center Experience with Midterm Follow-Up

Cagnazzo

Ahmed

Zannoni

et al. 2019

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

show abstract

“…9-13 Today, it is also used in narrow-neck aneurysms and sidewall aneurysms. 14 The therapy involves the placement of an intrasaccular device that alters the flow inside the aneurysm, inducing intrasaccular thrombosis. Introduced in 2010 in Europe, the Woven Endo-Bridge (WEB; Sequent Medical, Aliso Viejo, California) is the only intrasaccular device that has been extensively evaluated in the literature with several single-and multicenter, retrospective, and prospective series.…”

mentioning

confidence: 99%

“…Introduced in 2010 in Europe, the Woven Endo-Bridge (WEB; Sequent Medical, Aliso Viejo, California) is the only intrasaccular device that has been extensively evaluated in the literature with several single-and multicenter, retrospective, and prospective series. [9][10][11][12][13][14][15][16][17][18][19][20][21] Good Clinical Practice studies, including the WEB Clinical Assessment of IntraSaccular Aneurysm Therapy (WEBCAST) and the French Observatory studies, have shown a high level of safety with the device. [15][16][17][18] Efficacy has to be further evaluated, but 1-year anatomic results in both the WEB-CAST and French Observatory studies are encouraging.…”

mentioning

confidence: 99%

Safety and Efficacy of Aneurysm Treatment with the WEB: Results of the WEBCAST 2 Study

Piérot

Buhk

Holtmannspoetter

et al. 2017

AJNR Am J Neuroradiol

Self Cite

154

View full text Add to dashboard Cite

show abstract

“…The theoretical alternatives to the use of a combination of Medina and coils would have included a WEB device (Pierot et al 2017) or a pCONus-assisted coil occlusion (Signorelli et al 2017) with the need for dual platelet function inhibition.…”

Section: Discussionmentioning

confidence: 99%

Superior Cerebellar Artery Aneurysm: Spontaneous SAH, Occlusion of a Mid-sized, Wide-Necked Superior Cerebellar Artery Aneurysm with a Medina Device and Coils; Subsequent Coil Compaction, Treated with Flow Diversion Using a p64

Kalman¹,

AlMatter²,

Pérez³

et al. 2018

The Aneurysm Casebook

View full text Add to dashboard Cite

A 64-year-old male patient was brought to the referring hospital after an acute onset of a paresis of his right arm and a motoric aphasia without headache. Assuming an ischemic stroke, an MRI/MRA was performed, followed by a CT examination. These revealed a massive subarachnoid hemorrhage (SAH) from a mid-sized, wide-necked aneurysm at the origin of the left superior cerebellar artery (SCA). The aneurysm and in particular the rupture site were occluded with a Medina device (Medtronic) and conventional coils. The patient recovered well from the SAH. DSA 3 months after this treatment showed some coil compaction adjacent to the aneurysm neck. A second follow-up DSA 6 months after the initial treatment showed an increase of the aneurysm reperfusion, which was considered to be a sign of unstable aneurysm occlusion. To reduce the hemodynamic impact on the aneurysm remnant and to allow for a remodeling of the left SCA, a p64 (phenox) flow diverter was implanted from the left posterior cerebral artery (PCA) to the distal basilar artery (BA). This procedure was again well tolerated. A follow-up DSA examination 9.5 months after the first and 3 months after the second treatment showed decreased aneurysm reperfusion and an incomplete remodeling of the proximal segment of the left SCA. The management of wide-necked, ruptured aneurysms using Medina and secondary extrasaccular flow diversion is the main topic of this chapter.

show abstract

Should indications for WEB aneurysm treatment be enlarged? Report of a series of 20 patients with aneurysms in “atypical” locations for WEB treatment

Cited by 41 publications

References 22 publications

Predicting Factors of Angiographic Aneurysm Occlusion after Treatment with the Woven EndoBridge Device: A Single-Center Experience with Midterm Follow-Up

Predicting Factors of Angiographic Aneurysm Occlusion after Treatment with the Woven EndoBridge Device: A Single-Center Experience with Midterm Follow-Up

Safety and Efficacy of Aneurysm Treatment with the WEB: Results of the WEBCAST 2 Study

Superior Cerebellar Artery Aneurysm: Spontaneous SAH, Occlusion of a Mid-sized, Wide-Necked Superior Cerebellar Artery Aneurysm with a Medina Device and Coils; Subsequent Coil Compaction, Treated with Flow Diversion Using a p64

Contact Info

Product

Resources

About