WEB embolization of very broad-based intracranial aneurysms with a dome-to-neck ratio <= 1.1

Goertz, Lukas, Liebig, Thomas, Siebert, Eberhard, Pennig, Lenhard, Zaeske, Charlotte, Celik, Erkan ORCID: 0000-0001-5687-7707, Schlamann, Marc, Dorn, Franziska and Kabbasch, Christoph . WEB embolization of very broad-based intracranial aneurysms with a dome-to-neck ratio <= 1.1. Interv. Neuroradiol.. THOUSAND OAKS: SAGE PUBLICATIONS INC. ISSN 2385-2011

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DOI:10.1177/15910199221125102

Abstract

Objective The Woven EndoBridge (WEB) is a well-studied intrasaccular device for endovascular treatment of wide-necked bifurcation aneurysms. We evaluated the feasibility, safety and efficacy of the WEB for the treatment of very broad-based aneurysms with a dome-to-neck ratio <= 1.1. Methods Thirty-four aneurysms treated at three neurovascular centers were retrospectively identified. The mean aneurysm size was 5.5 +/- 1.6 mm with a mean neck width of 4.7 +/- 1.5 and a mean dome-to-neck ratio of 1.0 +/- 0.1. The primary outcome measures were immediate technical treatment success by WEB only, complete or near-complete occlusion at 6-month follow-up and ischemic stroke. Results Aneurysm embolization by WEB only was technically feasible in 79.4%. Additional stenting was required in 14.7%. In two aneurysms (5.9%), WEB implantation failed, and the aneurysm was treated by stent- and balloon-assisted coiling, respectively. Thromboembolic events occurred during 5 interventions (14.7%), all of these performed in ruptured aneurysms. One patient (2.9%) remained asymptomatic (follow-up modified Rankin scale [mRS] score: 0), 2 patients (5.9%) had a transient deficit (mRS 0 and 1, respectively), and 2 (5.9%) had a disabling ischemic stroke (mRS 3, respectively). Mid-term angiographic follow-up of 29 patients (4.0 +/- 2.6 months, range: 2-9 months) showed complete occlusion (WEB occlusion scale [WOS] A) in 41.4%, near-complete occlusion (WOS B) in 34.5%, a neck remnant (WOS C) in 10.3%, and aneurysm remnants (WOS D) in 13.8%. Conclusions WEB embolization of very broad-necked aneurysms was technically feasible and could be achieved by WEB only in the majority of cases. Considering the challenging anatomy of very broad-based aneurysms, the WEB procedure was reasonably safe and efficient.

Item Type:

Journal Article

Creators:

Creators	Email	ORCID	ORCID Put Code
Goertz, Lukas	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Liebig, Thomas	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Siebert, Eberhard	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Pennig, Lenhard	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Zaeske, Charlotte	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Celik, Erkan	UNSPECIFIED	orcid.org/0000-0001-5687-7707	UNSPECIFIED
Schlamann, Marc	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Dorn, Franziska	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Kabbasch, Christoph	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED