One-Year Angiographic Follow-Up after WEB-SL Endovascular Treatment of Wide-Neck Bifurcation Intracranial Aneurysms

Sivan-Hoffmann, Rotem; Gory, Benjamin; Riva, Roberto; Labeyrie, Paul‐Emile; Signorelli, Francesco; Eldesouky, Islam; Gonike-Sadeh, Udi; Armoiry, Xavier; Turjman, Francis

doi:10.3174/ajnr.a4457

Cited by 37 publications

(28 citation statements)

References 17 publications

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“…Our results showed that IA occlusion was stable and adequate at long term follow-up in this population of wide neck bifurcation IA that are prone to recanalization with other endovascular techniques 27. These findings confirm those of previous mid term12 17 and long term series 19. Moreover, it confirms that the small proximal recess related to the shape of the device should not be considered as a remnant and is stable over time 12.…”

Section: Discussionsupporting

confidence: 87%

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Endovascular treatment of intracranial aneurysms with the Woven EndoBridge device: mid term and long term results

Mine

Goutte

Brisbois

et al. 2017

J NeuroIntervent Surg

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Section: Discussionsupporting

confidence: 87%

“…Early series have reported good clinical and anatomical outcomes in unruptured8 10–14 and ruptured IA 9 15 16. However, few data are available on mid term12 17 18 and long term follow-up,19 which raise questions about long term stability of neck remnants related to potential device compression 17…”

Section: Introductionmentioning

confidence: 99%

Endovascular treatment of intracranial aneurysms with the Woven EndoBridge device: mid term and long term results

Mine

Goutte

Brisbois

et al. 2017

J NeuroIntervent Surg

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“…Consistent with this finding, a recent systematic review conducted by Armoiry et al 38 noted the need for additional treatment after the WEB was deployed in 8–15%. We also feel that the addition of an endoluminal flow diverter will help prevent compression of the MED, which has previously been reported to occur with the WEB in 25% of cases reported by Sivan-Hoffman et al 12 and in 57.2% of cases at early follow-up in the series by Cognard and Januel 11…”

Section: Discussionmentioning

confidence: 65%

“…This group also showed that compression of the WEB is possible and is likely involved in aneurysm recurrences. However, in a cohort of eight patients reported by Sivan-Hoffman et al ,12 only two had evidence of radiological deterioration at 12 months. These disparities highlight the need for further long-term evaluation of this device.…”

Section: Discussionmentioning

confidence: 84%

The Medina Embolic Device: early clinical experience from a single center

Pérez

Bhogal

Moreno

et al. 2016

J NeuroIntervent Surg

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ObjectiveTo report our initial experience with the Medina Embolic Device (MED) in unruptured intracranial aneurysms either as sole treatment or in conjunction with additional devices.Methods15 consecutive patients (6 women, 9 men) with unruptured aneurysms were treated between September 2015 and April 2016. The aneurysm fundus measured at least 5 mm. We evaluated the angiographic appearances of treated aneurysms at the end of the procedure and at follow-up, the clinical status, complications, and requirement for adjunctive devices.ResultsThe MED was successfully deployed in all but one case and adjunctive devices were required in 10 cases. Aneurysm locations were middle cerebral artery bifurcation (n=3), internal carotid artery (ICA) bifurcation (n=1), supraclinoid ICA (n=5), posterior communicating artery (n=1), anterior communicating artery (n=2), cavernous ICA (n=2), distal basilar sidewall (n=1), basilar tip (n=1). Three patients had complications although none could be attributed to the MED. Immediate angiographic results were modified Raymond-Roy classification (mRRC) I=1, mRRC II=5, mRRC IIIa=3, mRRC IIIb=5, and one patient showed contrast stasis within the fundus of the aneurysm. Follow-up angiography was available in 11 patients, with four showing complete aneurysm exclusion, six with stable remnants and one patient with an enlarging neck remnant.ConclusionsThe MED represents a major step forward in the treatment of intracranial aneurysms. It can result in rapid exclusion of an aneurysm from the circulation and has a good safety profile. We believe that the true value of the MED will be in combining its use with adjunctive devices such as endoluminal flow diverters that will result in rapid aneurysmal exclusion.

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“…Most of the published series comprised wide-necked, unruptured aneurysms. [4][5][6][7][8][9][10][11][12][13][14][15][16] When the WEB became available in our hospital, our initial results in unruptured aneurysms were encouraging, and we decided to expand the indications to both ruptured and unruptured aneurysms suitable for accommodating a WEB device, regardless of neck size. Our intention was to avoid using stents or balloons in ruptured aneurysms.…”

mentioning

confidence: 99%