A comparison between the CS-TOF and the CTA/DSA for WEB device management

Algın, Oktay; Yüce, Gökhan; Koç, Ural; Ayberk, Gıyas

doi:10.1177/15910199211014708

Cited by 5 publications

(11 citation statements)

References 16 publications

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“…Adequate occlusion rates of the WEB implantations were reported as 56–97% for 1-year follow-up. 2–8,10–16 Our first year and latest adequate occlusion rates (87% for both) are within the range of previously published papers and higher than other therapies for wide neck or bifurcation aneurysms. 2,7,8,10–16 The recurrence rate of WEB implantations in our study was low (13%).…”

Section: Discussionsupporting

confidence: 76%

“…1–3 Woven EndoBridge (WEB) has provided a paradigm change in endovascular treatment of these types of aneurysms. 2,4…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] Woven EndoBridge (WEB) has provided a paradigm change in endovascular treatment of these types of aneurysms. 2,4 The significant advantages of the WEB are the lack of periprocedural and long-standing antiplatelet medication necessity and the quick nature of the intervention. 3,5 Some studies have shown high safety and efficacy of the WEB in the short-term period.…”

Section: Introductionmentioning

confidence: 99%

“…3,5 Some studies have shown high safety and efficacy of the WEB in the short-term period. [4][5][6][7] Animal and human pilot studies revealed that intra-aneurysmal thrombus, aneurysm morphology, device migration to the aneurysmal fundus, and compression/compaction of the WEB had been associated with recurrences. [5][6][7][8][9] However, very few studies explored aneurysm characteristics potentially associated with occlusion rates in a midterm period.…”

Section: Introductionmentioning

confidence: 99%

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Long-term efficacy and safety of WovenEndoBridge (WEB)-assisted cerebral aneurysm embolization

2022

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Purpose Long-term compaction, compression, migration, and recurrence rates of the WovenEndoBridge devices remain unknown. The purpose of this study was to detect these rates and safety profiles of the WovenEndoBridge within 7 years period. Materials and methods Eighty-three aneurysms of 79 patients treated with the WovenEndoBridge device were retrospectively evaluated using an occlusion scale (e.g. complete occlusion, neck remnant, and aneurysm remnant) on angiography images. Results The residual aneurysm was observed in 11 (13%) aneurysms. The mean and median diameters of the recurrent aneurysms were 6 and 7 mm. Most of the recurrent aneurysms were complex type and/or ruptured. Mean diameters and the neck-to-body ratios of all residual aneurysms in the preoperative imaging exams were above 4 mm and 0.6, respectively. The median values of preoperative height and neck measurements were higher in the recurrent aneurysms than in the adequate occlusion group ( p = 0.006, p = 0.019, respectively). There was a statistically significant positive relationship between preoperative height/neck measurements and the mean diameters of residual aneurysms (rs = 0.32 and p = 0.003; rs = 0.28 and p = 0.011, respectively). The WovenEndoBridge compaction/compression and migration were observed in 5 (45%) and 2 (18%) of the recurrent aneurysms. In 7 (64%) of the residual aneurysms, thrombosed areas were found within the aneurysm. In the follow-up period, four aneurysms (4.8%) were retreated due to widened residual aneurysm. Other aneurysms were improved or stable within 7 years. Discussion Our adequate occlusion rate was 87%. Occlusion rates are less favorable than aneurysms with a long height, wide neck, or high neck-to-body ratio. Our study confirms the high safety and efficiency of the WovenEndoBridge. Compaction, compression, and/or migration of the WovenEndoBridge and the presence of intra-aneurysmal thrombosis are the main reasons for the recurrences.

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Section: Discussionsupporting

confidence: 76%

“…1–3 Woven EndoBridge (WEB) has provided a paradigm change in endovascular treatment of these types of aneurysms. 2,4…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Long-term efficacy and safety of WovenEndoBridge (WEB)-assisted cerebral aneurysm embolization

2022

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“…Morbidity and mortality risks of ruptured cerebral aneurysms are very high [1][2][3]. The perfect management of patients with cerebral aneurysms starts with optimal morphological analysis of the aneurysm and maximum information/education of the patients and their relatives.…”

Section: Introductionmentioning

confidence: 99%

Cerebrovascular modelling for the management of aneurysm embolization using an intrasaccular flow diverter made by 3D printing

Algın¹,

Keles²,

Oto³

2022

Pol J Radiol

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Purpose: Using 3-dimensional (3D) printers, the creation of patient-specific models is possible before and after a therapeutic intervention. There are many articles about replicas for training and simulation of aneurysm clipping. However, no paper has focused on 3D replicas obtained from 3-tesla 3D time of flight (3D-TOF) MR angiography for intrasaccular flow diverter (WEB device) embolization of the cerebral aneurysms. In this paper, we aimed to investigate the feasibility of 3D printing models obtained from 3-tesla 3D-TOF data in the management and training of WEB-assisted embolization procedures. Case presentation:We presented a longitudinal case report with several 3D-TOF MRA prints over time. Three-tesla 3D-TOF data were converted into STL and G-code files using an open-source (3D-Slicer) program. We built patient-specific realistic 3D models of a patient with a middle cerebral artery trifurcation aneurysm, which were able to demonstrate the entire WEB device treatment procedure in the pre-intervention and post-intervention periods. The aneurysmatic segment was well displayed on the STL files and the 3D replicas. They allowed visualization of the aneurysmatic segment and changes within a 6-year follow-up period. We successfully showed the possibility of fast, cheap, and easy production of replicas for demonstration of the aneurysm, the parent vessels, and post-intervention changes in a simple way using an affordable 3D printer.Conclusions: 3D printing is useful for training the endovascular team and the patients, understanding the aneurysm/ parent vessels, and choosing the optimal embolization technique/device. 3D printing will potentially lead to greater interventionalist confidence, decreased radiation dose, and improvements in patient safety.

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Ultra-High-Resolution Time-of-Flight MR-Angiography for the Noninvasive Assessment of Intracranial Aneurysms, Alternative to Preinterventional DSA?

et al. 2023

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Purpose The 3D time-of-flight (TOF) magnetic resonance angiography (MRA) at 3T shows high sensitivity for intracranial aneurysms but is inferior to three-dimensional digital subtraction angiography (3D-DSA) regarding aneurysm characteristics. We applied an ultra-high-resolution (UHR) TOF-MRA using compressed sensing reconstruction to investigate the diagnostic performance in preinterventional evaluation of intracranial aneurysms compared to conventional TOF-MRA and 3D-DSA. Methods In this study 17 patients with unruptured intracranial aneurysms were included. Aneurysm dimensions, configuration, image quality and sizing of endovascular devices were compared between conventional TOF-MRA at 3T and UHR-TOF with 3D-DSA as gold standard. Quantitatively, contrast-to-noise ratios (CNR) were compared between TOF-MRAs. Results On 3D-DSA, 25 aneurysms in 17 patients were detected. On conventional TOF, 23 aneurysms were detected (sensitivity: 92.6%). On UHR-TOF, 25 aneurysms were detected (sensitivity: 100%). Image quality was not significantly different between TOF and UHR-TOF (p = 0.17). Aneurysm dimension measurements were significantly different between conventional TOF (3.89 mm) and 3D-DSA (4.2 mm, p = 0.08) but not between UHR-TOF (4.12 mm) and 3D-DSA (p = 0.19). Irregularities and small vessels at the aneurysm neck were more frequently correctly depicted on UHR-TOF compared to conventional TOF. Comparison of the planned framing coil diameter and flow-diverter (FD) diameter revealed neither a statistically significant difference between TOF and 3D-DSA (coil p = 0.19, FD p = 0.45) nor between UHR-TOF and 3D-DSA (coil: p = 0.53, FD 0.33). The CNR was significantly higher in conventional TOF (p = 0.009). Conclusion In this pilot study, ultra-high-resolution TOF-MRA visualized all aneurysms and accurately depicted aneurysm irregularities and vessels at the base of the aneurysm comparably to DSA, outperforming conventional TOF. UHR-TOF with compressed sensing reconstruction seems to represent a non-invasive alternative to pre-interventional DSA for intracranial aneurysms.

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A comparison between the CS-TOF and the CTA/DSA for WEB device management

Cited by 5 publications

References 16 publications

Long-term efficacy and safety of WovenEndoBridge (WEB)-assisted cerebral aneurysm embolization

Long-term efficacy and safety of WovenEndoBridge (WEB)-assisted cerebral aneurysm embolization

Cerebrovascular modelling for the management of aneurysm embolization using an intrasaccular flow diverter made by 3D printing

Ultra-High-Resolution Time-of-Flight MR-Angiography for the Noninvasive Assessment of Intracranial Aneurysms, Alternative to Preinterventional DSA?

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