WEB in Partially Thrombosed Intracranial Aneurysms: A Word of Caution

Abstract

SUMMARY:Despite the proved safety and efficacy of Woven EndoBridge (WEB) flow disruption in conventional intracranial saccular aneurysms, the literature on its use in partially thrombosed intracranial aneurysms is scarce. We report a series of 4 patients in whom partially thrombosed intracranial aneurysms were treated with the WEB. The 2 patients who received additional intraluminal treatment with conventional stents made a good clinical recovery. Meanwhile, those patients who were treated with the WEB alone had fatal rupture of the aneurysm at short-to medium-term follow-up. This small, select case series demonstrates that WEB placement with adjunctive stent placement may be an effective treatment in the management of partially thrombosed intracranial aneurysms, which merits further validation. However, exclusive intrasaccular flow disruption may have an adverse influence on the natural history of this disease.

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

“…This may be explained by the fact that we initially included very large and partially thrombosed IA. It has been reported26 and confirmed in our experience that the device may progressively migrate in the clot and/or the aneurysm resulting in incomplete occlusion (figure 3). Inadequate sizing in the early experience may also explain some of these retreatments as significant remnants were left to avoid device protrusion.…”

The LUNA aneurysm embolization system for intracranial aneurysm treatment: short-term, mid-term and long-term clinical and angiographic results

“…Retreatment was performed in four subjects because the LUNA AES device behaved similarly to coils in those instances: the implant progressively migrated within the preexisting aneurysmal fundus clot in a manner previously observed with the WEB device 21. The LUNA AES retreatment rates observed in this study are similar to those seen with the WEB device and with bare and hydrogel coils 11 22.…”

Endovascular Treatment with the pCONus Device: Initial Experience in a Single UK Centre

“…X, Y, T, and linear stenting involve a complex delivery technique as they all require the use of more than one stent [11,15,16]. More recent advances include the use of a Woven EndoBridge (WEB) device which is a braided nitinol mesh that functions as an intrasaccular flow disruptor [17][18][19][20]. One of our patients with an AComA aneurysm treated with pCONus had a recurrence following utilisation of the WEB device previously.…”