Lubicz, B., Klisch, J., Gauvrit, J. -Y., Szikora, I., Leonardi, M., Liebig, T., Nuzzi, N. P., Boccardi, E., Paola, F. D., Holtmannspotter, M., Weber, W., Calgliari, E., Sychra, V., Mine, B. and Pierot, L. (2014). WEB-DL Endovascular Treatment of Wide-Neck Bifurcation Aneurysms: Short- and Midterm Results in a European Study. Am. J. Neuroradiol., 35 (3). S. 432 - 439. DENVILLE: AMER SOC NEURORADIOLOGY. ISSN 1936-959X

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Abstract

Short- and midterm results of endovascular aneurysm treatment with the new WEB-DL device were assessed in 45 patients from 12 European centers. Of these, 42 aneurysms were unruptured and most were located either in the MCA bifurcation or the posterior circulation. Adequate occlusion was observed in 81% and 90% of aneurysms at 6 and 13 months, respectively. Results suggest that WEB endovascular treatment of wide-neck bifurcation aneurysms offers stable occlusion in a class of aneurysms that are historically unstable. BACKGROUND AND PURPOSE: Flow disruption with the WEB-DL device has been used safely for the treatment of wide-neck bifurcation aneurysms, but the stability of aneurysm occlusion after this treatment is unknown. This retrospective multicenter European study analyzed short- and midterm data in patients treated with WEB-DL. MATERIALS AND METHODS: Twelve European neurointerventional centers participated in the study. Clinical data and pre- and postoperative short- and midterm images were collected. An experienced interventional neuroradiologist independently analyzed the images. Aneurysm occlusion was classified into 4 grades: complete occlusion, opacification of the proximal recess of the device, neck remnant, and aneurysm remnant. RESULTS: Forty-five patients (34 women and 11 men) 35-74 years of age (mean, 56.3 +/- 9.6 years) with 45 aneurysms treated with the WEB device were included. Aneurysm locations were the middle cerebral artery in 26 patients, the posterior circulation in 13 patients, the anterior communicating artery in 5 patients, and the internal carotid artery terminus in 1 patient. Forty-two aneurysms were unruptured. Good clinical outcome (mRS < 2) was observed in 93.3% of patients at the last follow-up. Adequate occlusion (complete occlusion, opacification of the proximal recess, or neck remnant) was observed in 30/37 patients (81.1%) in short-term follow-up (median, 6 months) and in 26/29 patients (89.7%) in midterm follow-up (median, 13 months). Worsening of the aneurysm occlusion was observed in 2/28 patients (7.1%) at midterm follow-up. CONCLUSIONS: The results suggest that the WEB endovascular treatment of wide-neck bifurcation aneurysms offers stable occlusion in a class of aneurysms that are historically unstable. Additionally, our data show that opacification of the WEB recess can be delineated from true neck or aneurysm remnants.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Lubicz, B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klisch, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gauvrit, J. -Y.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Szikora, I.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Leonardi, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Liebig, T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nuzzi, N. P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boccardi, E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Paola, F. D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Holtmannspotter, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weber, W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Calgliari, E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sychra, V.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mine, B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pierot, L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-444349
DOI: 10.3174/ajnr.A3869
Journal or Publication Title: Am. J. Neuroradiol.
Volume: 35
Number: 3
Page Range: S. 432 - 439
Date: 2014
Publisher: AMER SOC NEURORADIOLOGY
Place of Publication: DENVILLE
ISSN: 1936-959X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
INTRACRANIAL ANEURYSMS; FLOW-DISRUPTION; COILINGMultiple languages
Clinical Neurology; Neuroimaging; Radiology, Nuclear Medicine & Medical ImagingMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/44434

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